NPI | 1063779460 |
---|---|
Entity Type | Organization |
Authorized Contact | ALICIA JEAN BEYNON Owner/Director 855-692-7247 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OH I.0700055-SUPV) |
Enumeration Date | 2012-04-23 |
Last Update Date | 2022-07-21 |