| NPI | 1083362834 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PEGGY ANDERSON CEO 419-526-7880 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 3336C0002X Pharmacy Clinic Pharmacy | |
| Enumeration Date | 2022-03-11 |
| Last Update Date | 2022-03-11 |