| NPI | 1376518902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIA VOGT Business Manager 419-747-0881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: OH FACSIS 256) |
| Additional Taxonomies | 261QM0801X (Licence: OH 0680) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2022-06-13 |