| NPI | 1144979147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUDRA MARIE POPIK Provider/Owner 440-839-6037 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2022-03-18 |
| Last Update Date | 2022-03-18 |