| NPI | 1144728833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH SCOTT HODGES President 419-320-2773 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2018-01-27 |
| Last Update Date | 2018-01-27 |