| NPI | 1356303911 |
|---|---|
| Former Legal Business Name | CROSSROADS LAKE COUNTY ADOLESCENT COUNSELING SERVICES |
| Entity Type | Organization |
| Authorized Contact | ALICE IDEN COO 440-255-1700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2021-07-19 |