| NPI | 1174222053 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHONDA ELLEN WALLACE CFO 937-324-1111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2023-02-28 |
| Last Update Date | 2024-11-20 |