| NPI | 1871820019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA PACK COLLEN Clinical Counselor Supervisor 740-522-4673 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X (Licence: OH E0007806) |
| Enumeration Date | 2009-11-09 |
| Last Update Date | 2014-05-16 |