| NPI | 1184230906 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELIQUE GLYDA Credentialing Manager 419-380-0116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-09-17 |
| Last Update Date | 2020-09-17 |