| NPI | 1265941793 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NSILULU JACKSON Executive Director 937-222-5680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2017-09-27 |
| Last Update Date | 2022-07-21 |