| NPI | 1407311202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETHANY T LATIMER Owner 330-577-6656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2019-02-05 |
| Last Update Date | 2022-06-30 |