| NPI | 1063194637 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAQUITA DORMAN Owner 216-299-1305 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2023-08-03 |
| Last Update Date | 2023-08-03 |