NPI | 1740175496 |
---|---|
Entity Type | Organization |
Authorized Contact | DESHRA VINES-LEAK Health Care Administrator 419-410-9438 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
1041C0700X Social Worker, Clinical | |
251B00000X Case Management | |
251S00000X Community/Behavioral Health | |
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
Enumeration Date | 2025-06-12 |
Last Update Date | 2025-06-12 |