| NPI | 1619339090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY KOMAC CEO 440-703-0941 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QI0500X Clinic/Center, Infusion Therapy |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2016-03-24 |
| Last Update Date | 2016-03-24 |