| NPI | 1639341258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK WINGERT Controller 330-743-9275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: OH 0305) |
| Enumeration Date | 2008-03-25 |
| Last Update Date | 2008-05-30 |