| NPI | 1760741110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLIE J DAWSON Owner 614-946-7571 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OH I. 0009062 SUPV) |
| Enumeration Date | 2012-05-04 |
| Last Update Date | 2015-09-16 |