| NPI | 1700594900 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MASON YODER Consultant 330-554-4009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2022-11-07 |
| Last Update Date | 2023-07-06 |