| NPI | 1194733121 |
|---|---|
| Other Name | SUB PROVIDER PSYCH |
| Entity Type | Organization |
| Authorized Contact | TIMOTHY D. SNIDER Vice President Finance 937-440-7853 |
| Organization Subpart ? | No |
| Primary Taxonomy | 273R00000X Psychiatric Unit (Licence: OH 052386) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2020-08-22 |