| NPI | 1104428960 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LACRESHA MARIE ROX Owner 216-372-0349 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-11-16 |
| Last Update Date | 2021-01-21 |