| NPI | 1063230746 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATISHA L ROBINSON Program Director 937-307-2973 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251B00000X Case Management |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2024-10-01 |
| Last Update Date | 2024-10-01 |