| NPI | 1326530585 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASONDRA RENEE ROBINSON CEO 800-395-4564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: OH 121001) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: OH 121001) |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2018-06-04 |