NPI | 1093475899 |
---|---|
Entity Type | Organization |
Authorized Contact | TANIA S LODGE Psychologist/Director 330-271-6160 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health |
Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
261QM0855X Clinic/Center Adolescent and Children Mental Health | |
Enumeration Date | 2021-12-21 |
Last Update Date | 2022-03-01 |