| NPI | 1194395897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEONNA T JACKSON Owner 419-870-9461 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2021-06-25 |
| Last Update Date | 2021-12-01 |