| NPI | 1740116607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHEL PETRICK Tax Id Owner 440-879-1258 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2026-06-19 |
| Last Update Date | 2026-06-19 |