| NPI | 1053479170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KOTESWARA R KAZA Medical Director 330-385-8800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: OH 042814) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2020-08-22 |