| NPI | 1720029622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL SAMUEL BOLINO CEO 440-998-4210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: OH 0166) |
| Additional Taxonomies | 251B00000X Case Management (Licence: OH 0166) |
| 261QM0850X Clinic/Center, Adult Mental Health (Licence: OH 0166) | |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2015-03-04 |