| NPI | 1568722171 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA MONTGOMERY CEO 419-774-6705 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder (Licence: OH 04158) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: OH 13000) |
| Enumeration Date | 2012-05-17 |
| Last Update Date | 2021-04-12 |