| NPI | 1487168084 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT WILKES Owner 330-714-0938 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2017-11-20 |
| Last Update Date | 2017-11-20 |