| NPI | 1629684725 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HASHEEN WILSON Owner 330-234-5251 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
| Enumeration Date | 2020-09-23 |
| Last Update Date | 2023-03-20 |