| NPI | 1093356610 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCUS GOODWIN Vice President 419-944-8845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2019-10-04 |
| Last Update Date | 2024-07-31 |