| NPI | 1104336296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA SUE LESTER-BLACK Managing Member 419-280-5890 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OH E.1700263) |
| Enumeration Date | 2017-10-03 |
| Last Update Date | 2018-01-31 |