| NPI | 1063653871 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID L. WATTS Owner & Manager 440-409-8690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OH I-1101288) |
| Enumeration Date | 2009-03-09 |
| Last Update Date | 2012-10-09 |