| NPI | 1659736155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOLLY LUCKNER Clinical Social Worker 330-704-5377 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OH I1200474) |
| Enumeration Date | 2015-12-28 |
| Last Update Date | 2015-12-28 |