| NPI | 1770391542 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM DE'ANGELO STINCHCOMB Owner 614-347-9455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-12-24 |
| Last Update Date | 2024-12-25 |