| NPI | 1700341922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WINOLA SUE SPRAGUE Medical Director 330-330-8655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2019-02-01 |
| Last Update Date | 2019-02-01 |