| NPI | 1033413729 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PENNY LEWIS Supervisor 419-234-9178 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OH C0900496) |
| Enumeration Date | 2011-01-10 |
| Last Update Date | 2021-11-04 |