| NPI | 1245858950 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PEGGY ANDERSON CEO 419-522-6191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 261QP1100X Clinic/Center Podiatric | |
| Enumeration Date | 2020-07-09 |
| Last Update Date | 2024-10-29 |