Organization
BROCKTON HEALTHCARE NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AUGUSTINE M. NORRIS MBA(MANAGEMENT) (CEO)
(614) 367-6051
Entity
Organization
Contact information
Practice address
5701 SPRUCE TREE DR, COLUMBUS, OH 43232-7751
(614) 367-6051
Mailing address
5701 SPRUCE TREE DR, COLUMBUS, OH 43232-7751
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
SB612704
OH
Other
Enumeration date
03/27/2009
Last updated
03/27/2009
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