| NPI | 1225688906 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA MARIE HOLLO Director 440-406-8006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-09-16 |
| Last Update Date | 2019-11-13 |