| NPI | 1407057615 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WESLEY A BULLOCK Director 419-530-2721 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OH 3856) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2012-08-14 |