| NPI | 1649501776 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAQUEL WILSON Clinical Social Worker 419-704-2938 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OH I.0800109-SUPV) |
| Enumeration Date | 2010-01-29 |
| Last Update Date | 2010-07-27 |