| NPI | 1235911611 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHILOH MCCLELLAND Administrator 330-227-2291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2023-10-19 |
| Last Update Date | 2024-12-02 |