| NPI | 1609699644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY L FERGUSON Owner 330-907-4391 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 251B00000X Case Management | |
| 251S00000X | |
| Enumeration Date | 2024-11-07 |
| Last Update Date | 2024-11-07 |