| NPI | 1871828012 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOLANDA LYNN QUEEN Director 740-286-5713 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: OH 324500000X) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2009-10-06 |
| Last Update Date | 2012-05-14 |