| NPI | 1124592894 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH ALEXANDER Clinical Supervisor 216-444-1195 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2019-01-16 |
| Last Update Date | 2019-01-16 |