| NPI | 1972860070 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN J WAGNER President 614-863-2399 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OH 5746) |
| Enumeration Date | 2012-04-13 |
| Last Update Date | 2012-04-13 |