| NPI | 1508303538 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN M BRANDT Owner 937-214-5367 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MO LC001522831) |
| Enumeration Date | 2017-01-29 |
| Last Update Date | 2017-01-30 |