| NPI | 1336523877 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON GROVES Co Owner 513-465-2885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 954407) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 140273) |
| Enumeration Date | 2015-07-15 |
| Last Update Date | 2015-07-15 |