| NPI | 1679140040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DESMOND EUGENE YANAMAYU Clinical Director 330-518-4863 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2021-06-05 |
| Last Update Date | 2021-06-05 |