NPI | 1609689033 |
---|---|
Entity Type | Organization |
Authorized Contact | JENNIE EWALD Administrator 937-414-1948 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
Enumeration Date | 2025-01-29 |
Last Update Date | 2025-01-29 |