Organization
MARYHAVEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHNIESE G HORTON CDCA/ ON HOLD (PCA)
(614) 892-2454
Entity
Organization
Contact information
Practice address
100 NOE BIXBY RD, COLUMBUS, OH 43213-1460
(614) 702-4503
Mailing address
100 NOE BIXBY RD, COLUMBUS, OH 43213-1460
(614) 702-4503
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/27/2018
Last updated
09/27/2018
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