NPI | 1285907501 |
---|---|
Entity Type | Organization |
Authorized Contact | RONALD DWINNELLS CEO 330-747-9551 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 207Q00000X Family Medicine |
207R00000X Internal Medicine | |
2080A0000X Pediatrics Adolescent Medicine | |
213E00000X Podiatrist | |
261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
101YA0400X Counselor Addiction (Substance Use Disorder) | |
103G00000X Clinical Neuropsychologist | |
1041C0700X Social Worker Clinical | |
Enumeration Date | 2012-02-16 |
Last Update Date | 2024-10-15 |