| NPI | 1891564480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER BONINE Provider 614-740-3365 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-12-25 |
| Last Update Date | 2023-12-25 |