| NPI | 1093257859 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS IVANY CEO 330-270-3660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101Y00000X Counselor |
| 207RA0401X Internal Medicine, Addiction Medicine | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2016-11-10 |
| Last Update Date | 2020-06-02 |