| NPI | 1659712859 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA L FUENTES Clinician/ Owner 440-488-4081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OH E8454) |
| 261QM0850X Clinic/Center, Adult Mental Health (Licence: OH E8454) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2013-07-16 |
| Last Update Date | 2013-07-24 |