| NPI | 1619158110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENT ANTONY BASILE Clinical Social Worker 216-374-8382 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I.0700026) |
| Enumeration Date | 2007-11-26 |
| Last Update Date | 2007-11-26 |