| NPI | 1164823175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAVAUN GRAVES JONES Owner 216-533-0961 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OH E.0800148) |
| Enumeration Date | 2014-09-09 |
| Last Update Date | 2014-09-09 |