Individual provider · Type 1 NPI
Jaz Cicero Santana Boyce
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Columbus, OH
Practice location
3118 Houston Dr
Columbus, OH 43207-3398
Other practice locations
- 2167 Mock Rd, Columbus, OH 43219-1284 · (614) 407-6352
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physical Disabilities Residential Treatment Facility | 320700000X | None listed |
| Mental Illness Community Based Residential Treatment Facility | 320800000X | None listed |
| Emotionally Disturbed Childrens' Residential Treatment Facility | 322D00000X | None listed |
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary | 320900000X | None listed |
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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- Kodjo AbaloIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Columbus, OH NPI 1407619810
- Sincerea HilsonIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Columbus, OH NPI 1548129273
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About NPI 1083067896
Jaz Cicero Santana Boyce's National Provider Identifier is 1083067896, issued on Jul 16, 2016. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Columbus, OH. The record was last updated on Jun 6, 2023.