| NPI | 1386698215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY LEE NEUENDORF President/CEO/Owner 330-629-2888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| 1041C0700X Social Worker, Clinical | |
| 207L00000X Anesthesiology | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine | |
| 364SP0808X Clinical Nurse Specialist, Psych/Mental Health | |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2018-08-21 |