| NPI | 1679053268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLIE MCMASTER Clinical Social Worker 937-336-6950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-08-14 |
| Last Update Date | 2018-08-14 |