| NPI | 1659722569 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN FLETCHER Billing Manager 216-831-6466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OH C.1400054-CR) |
| Enumeration Date | 2016-06-22 |
| Last Update Date | 2016-06-22 |