| NPI | 1790317105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FATIMA SILLAH Director 614-352-6642 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2020-02-04 |
| Last Update Date | 2020-02-04 |