| NPI | 1053309294 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRENCE B. DALTON CEO 330-996-9141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: OH 9928171) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH 9928171) |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2008-04-02 |