| NPI | 1255621991 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIRLEY SHARP Business Administrator 440-934-6152 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: OH 4710838) |
| Enumeration Date | 2011-04-14 |
| Last Update Date | 2011-04-14 |