| NPI | 1376163691 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENT A CRANE Owner 937-367-6496 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-04-17 |
| Last Update Date | 2021-07-13 |