| NPI | 1013097542 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL MATONEY Executive Director 216-591-0324 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: OH 1848201) |
| Additional Taxonomies | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: OH 1848201) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2020-08-22 |