| NPI | 1043519168 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN W FORD Owner 740-701-6798 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH 0003798) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral (Licence: OH 0003798) |
| 101Y00000X Counselor (Licence: OH 0003798) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 0003798) | |
| 101YM0800X Counselor, Mental Health (Licence: OH 0003798) | |
| Enumeration Date | 2011-03-16 |
| Last Update Date | 2011-03-16 |