| NPI | 1982148870 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN MOORE CEO 614-504-6470 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: FL 1101) |
| Enumeration Date | 2016-12-12 |
| Last Update Date | 2022-07-21 |