| NPI | 1659097582 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE HURD Credentialing 330-631-4087 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-10-12 |
| Last Update Date | 2022-10-12 |