| NPI | 1003568445 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHESTER RALEIGH Owner 937-242-0326 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2022-01-26 |
| Last Update Date | 2022-01-26 |