| NPI | 1447594346 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA JEAN MORONTI FORSTER Clinical Counselor 419-482-8244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: OH 2138575) |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2013-02-01 |