| NPI | 1659810125 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DON KERMATH Rcm 217-621-4979 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 151226) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OH 151226) |
| 251B00000X Case Management (Licence: OH 151226) | |
| Enumeration Date | 2017-02-17 |
| Last Update Date | 2025-02-05 |