Healthcare Provider Details

I. General information

NPI: 1093008328
Provider Name (Legal Business Name): DIRECTIONS FOR YOUTH AND FAMILIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2011
Last Update Date: 05/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1414 E BROAD ST
COLUMBUS OH
43205-1505
US

IV. Provider business mailing address

1414 E BROAD ST
COLUMBUS OH
43205-1505
US

V. Phone/Fax

Practice location:
  • Phone: 614-251-0103
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberE0500232
License Number StateOH

VIII. Authorized Official

Name: MR. STEVE VOTAW
Title or Position: CEO
Credential:
Phone: 614-294-2661