| NPI | 1518774801 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL MAHARIDGE Credentialing Manager 440-366-5628 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 344600000X Taxi |
| Enumeration Date | 2024-12-11 |
| Last Update Date | 2024-12-27 |