| NPI | 1982223699 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOMIKA GORDON CEO 614-946-5504 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology Addiction Psychiatry |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 163WA0400X Registered Nurse Addiction (Substance Use Disorder) | |
| 164W00000X Licensed Practical Nurse | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2020-04-13 |
| Last Update Date | 2020-09-18 |