| NPI | 1033809447 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAUNTAP PATRICK Owner/Lpn 419-215-4131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 251B00000X Case Management | |
| 261QR0800X Clinic/Center, Recovery Care | |
| Enumeration Date | 2023-05-09 |
| Last Update Date | 2023-05-09 |