| NPI | 1629144050 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MYRTLE B. BOYKIN-LIGHTON Executive Director 419-222-4474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center Community Health (Licence: OH 5004) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2019-11-12 |