| NPI | 1104365691 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAJA ANDERSON Owner 419-528-5993 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OH 01-7574) |
| Enumeration Date | 2017-02-16 |
| Last Update Date | 2017-02-16 |