| NPI | 1114439239 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONY RITTER Credentialing Specialist 740-773-4366 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2017-10-30 |
| Last Update Date | 2019-07-05 |