| NPI | 1730700725 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI L BALLEIN Owner 937-402-8600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2020-04-30 |
| Last Update Date | 2020-05-04 |