Organization
OHIO YOUTH ADVOCATE PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JOAN M WILSON (EXECUTIVE DIRECTOR)
(614) 921-2111
Entity
Organization
Contact information
Practice address
1445 SUMMIT ST, COLUMBUS, OH 43201-2105
(614) 523-1001
(614) 583-1003
Mailing address
6233 RIVERSIDE DR, DUBLIN, OH 43017-5069
(614) 717-8000
(614) 717-8020
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
10709
OH
251K00000X
Public Health or Welfare Agency
353
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10178
—
OH
Enumeration date
04/17/2006
Last updated
08/22/2020
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