| NPI | 1124784251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE HILL Credentialing Coordinator 419-494-9310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2021-11-12 |
| Last Update Date | 2021-11-12 |