| NPI | 1952978686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE RICHARD BERK Managing Director 614-907-5434 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2021-06-10 |
| Last Update Date | 2021-07-19 |