| NPI | 1548642259 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY N GRINONNEAU Owner 419-410-4476 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OH E.0700483-SUPV) |
| Enumeration Date | 2015-06-18 |
| Last Update Date | 2015-06-18 |