| NPI | 1639442841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINARI RENE PRICE Owner 216-630-0716 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: GA 056712) |
| Additional Taxonomies | 261QD1600X Clinic/Center, Developmental Disabilities (Licence: GA 056712) |
| 261QM0850X Clinic/Center, Adult Mental Health (Licence: GA 056712) | |
| Enumeration Date | 2012-02-18 |
| Last Update Date | 2012-02-18 |