| NPI | 1033268859 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KOTESWARA R. KAZA Medical Director And Owner 330-797-4050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 965575) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OH E0002791) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2020-08-22 |