| NPI | 1477920205 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD DWINNELLS CEO 330-747-9551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 124Q00000X Dental Hygienist |
| 101YM0800X Counselor, Mental Health | |
| 207Q00000X Family Medicine | |
| 122300000X Dentist | |
| 207VG0400X Obstetrics & Gynecology, Gynecology | |
| 213E00000X Podiatrist | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2015-08-27 |
| Last Update Date | 2017-12-14 |