| NPI | 1003314733 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN M ILES Business Manager 419-281-3716 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2018-01-29 |
| Last Update Date | 2018-01-29 |