| NPI | 1104897198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK WINGERT Controller 330-743-9275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management (Licence: OH 0305) |
| Additional Taxonomies | 251V00000X Voluntary or Charitable (Licence: OH 0305) |
| 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: OH 04-2038) | |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2020-08-22 |