| NPI | 1013059179 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN B WILHELM Medical Supervisor 440-331-2899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 83876) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH C1743) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2020-08-22 |