| NPI | 1255777090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAUTHAM VYAS MOHAN KRISHNA MADHIRA President Of Board Of Trustees 419-480-9124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2013-05-20 |
| Last Update Date | 2013-05-20 |