| NPI | 1356019657 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWAN SHORT Owner 330-431-3344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2021-09-01 |
| Last Update Date | 2021-09-01 |