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Organization

MALE BEHAVIORAL HEALTH

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JEWEL WOODS JR. LISW (EXECUTIVE DIRECTOR)
(216) 224-5472
Entity
Organization

Contact information

Practice address
1298 CRYSTAL TREE CT, BLACKLICK, OH 43004-8247
(614) 454-1039
Mailing address
1298 CRYSTAL TREE CT, BLACKLICK, OH 43004-8247
(216) 224-5472

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
04/08/2019
Last updated
07/02/2019
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