| NPI | 1174166516 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DWAYNE LEE GIBSON CEO 419-705-8682 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251B00000X Case Management |
| 174200000X Meals | |
| Enumeration Date | 2019-10-17 |
| Last Update Date | 2019-10-17 |