Organization
SCIOTO TRAILS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID RASTOKA (OWNER)
(614) 425-6058
Entity
Organization
Contact information
Practice address
149 W WATER ST, CHILLICOTHE, OH 45601-2423
(419) 631-2112
Mailing address
5767 KEMPTON RUN CT, COLUMBUS, OH 43235-3509
(614) 425-6058
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6601298
—
OH
Enumeration date
02/11/2021
Last updated
02/11/2021
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