| NPI | 1689028789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN THOMAS BONEY Clinical Director 330-209-0604 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2016-04-15 |
| Last Update Date | 2025-03-10 |