| NPI | 1093772386 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH BOND Executive Director 419-782-9920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: OH 0559) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: OH 0559) |
| 332900000X Non-Pharmacy Dispensing Site (Licence: OH 0559) | |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2020-08-22 |