| NPI | 1851862601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAXINE MALONE Director 740-727-4801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 251B00000X Case Management |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2018-12-05 |
| Last Update Date | 2018-12-05 |