| NPI | 1124206594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDON WELTON Program Director 937-257-1363 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 273R00000X Psychiatric Unit |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 282N00000X General Acute Care Hospital | |
| 283Q00000X Psychiatric Hospital | |
| 286500000X Military Hospital | |
| Enumeration Date | 2008-02-07 |
| Last Update Date | 2025-03-12 |