| NPI | 1740858182 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY YODER Authorized Official 419-889-1928 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2021-06-13 |
| Last Update Date | 2023-01-06 |