| NPI | 1093256364 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY RENNE BURNETT Mental Health Nurse 216-651-9950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: OH PN137174-M-IV) |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2017-03-20 |