| NPI | 1083208748 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUANITA ELLIS Nurse Practitioner 419-963-4299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-02-23 |
| Last Update Date | 2024-07-02 |