| Directly Affected Llc | |
|
1206 Waller Street Portsmouth OH 45662 | |
| (614) 980-2116 | |
| Not Available |
| Full Name | Directly Affected Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1206 Waller Street, Portsmouth, Ohio |
| Authorized Official Name and Position | Dominique Myrick (OWNER) |
| Authorized Official Contact | 6149802116 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Directly Affected Llc 2522 S Terripin Mesa AZ 85209-4959 Ph: () - | Directly Affected Llc 1206 Waller Street Portsmouth OH 45662 Ph: (614) 980-2116 |
| NPI Number | 1396454047 |
|---|---|
| Provider Enumeration Date | 11/22/2022 |
| Last Update Date | 11/22/2022 |
| Certification Date | 11/22/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396454047 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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