NPI 1083067896

Jaz Cicero Santana Boyce

Practitioner Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Columbus, OH

Practice location

Address: 3118 Houston Dr, Columbus, OH 43207-3398
Phone: (614) 407-6352

Registered specialties (4)

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320900000X

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Physical Disabilities Residential Treatment Facility

Residential Treatment Facilities Taxonomy 320700000X

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Mental Illness Community Based Residential Treatment Facility

Residential Treatment Facilities Taxonomy 320800000X

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Emotionally Disturbed Childrens' Residential Treatment Facility

Residential Treatment Facilities Taxonomy 322D00000X

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Registry record

NPI: 1083067896
Entity type: Individual
Sex (as registered): Male
NPI issued: 16 Jul 2016
Record last updated: 6 Jun 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.