Organization
SURVIVOR ADVOCACY OUTREACH PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MADISON NMI TRACE (COO)
(740) 274-1727
Entity
Organization
Contact information
Practice address
55 W WASHINGTON ST, NELSONVILLE, OH 45764-1134
(740) 591-4266
Mailing address
55 W WASHINGTON ST, NELSONVILLE, OH 45764-1134
(740) 591-4266
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
09/28/2023
Last updated
02/04/2025
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