| NPI | 1013420579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDI ROSE GRABASCH Lamft 419-204-6612 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: NM 0182281) |
| Enumeration Date | 2017-11-07 |
| Last Update Date | 2017-11-07 |