| NPI | 1629843834 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN ALBERT LEE CEO 440-578-8200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2023-11-17 |
| Last Update Date | 2023-11-17 |