Organization
CARESTAR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE A BRYAN (INDEPANT PROVIDER)
(740) 382-5425
Entity
Organization
Contact information
Practice address
134 E COLUMBIA ST, MARION, OH 43302-3904
(740) 382-5425
Mailing address
134 E COLUMBIA ST, MARION, OH 43302-3904
(740) 382-5425
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2148170
—
OH
Enumeration date
04/10/2007
Last updated
08/22/2020
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