Organization
FATHERLY INSTRUCTION FOR REBUILDING MEN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARLON GOOLSBY (CEO)
(740) 963-2073
Entity
Organization
Contact information
Practice address
785 BRENTNELL AVE, COLUMBUS, OH 43219-2571
(740) 963-2073
Mailing address
785 BRENTNELL AVE, COLUMBUS, OH 43219-2571
(740) 963-2073
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
—
Other
Enumeration date
02/28/2024
Last updated
02/28/2024
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