| NPI | 1548701956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEILA MARIE CLARK Chemical Dependency Counselor 419-722-8932 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: OH 011031) |
| Enumeration Date | 2017-03-17 |
| Last Update Date | 2017-03-17 |