| NPI | 1588398655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANTAE M WILLIAMS Employee 937-684-7105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-07-13 |
| Last Update Date | 2022-07-26 |