| NPI | 1467919605 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE SUSAN DERUE Vice President 330-264-9029 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2019-02-25 |
| Last Update Date | 2019-02-25 |