| NPI | 1164865713 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA LEE MCMULLIN Clinical Director 330-305-9100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OH E.0700447-SUPV) |
| 364SP0810X Clinical Nurse Specialist, Psych/Mental Health, Child & Family (Licence: OH RN173920) | |
| Enumeration Date | 2013-04-14 |
| Last Update Date | 2023-03-31 |