| NPI | 1215919527 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY FRANK KOLACZKOWSKI Executive Director 937-223-1781 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: OH 11218) |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2020-08-22 |