| NPI | 1053540302 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTEN JON GROSS Family Counselor 216-403-4177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH S. 0030847) |
| Enumeration Date | 2009-07-08 |
| Last Update Date | 2009-08-08 |