| NPI | 1154505634 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS T MILLER Director 419-238-6646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OH 1381) |
| Enumeration Date | 2007-12-20 |
| Last Update Date | 2007-12-20 |