| NPI | 1598941080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADINA LYNNE FOX Owner 419-207-1122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OH I-9171) |
| Enumeration Date | 2008-01-14 |
| Last Update Date | 2008-08-27 |