| NPI | 1134837396 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUANITA RANDLE Administrator 330-212-4971 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2022-11-07 |
| Last Update Date | 2022-11-07 |