| NPI | 1114492147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA BAHRY Director Of Accounting 330-253-3100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2018-10-05 |
| Last Update Date | 2018-10-05 |