| NPI | 1750176590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL DALTON CEO 216-410-1413 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 103TC0700X Psychologist Clinical | |
| 103TC1900X Psychologist Counseling | |
| 103TH0004X Psychologist Health | |
| 207QA0505X Family Medicine Adult Medicine | |
| 363AM0700X Physician Assistant Medical | |
| 363LP2300X Nurse Practitioner Primary Care | |
| Enumeration Date | 2025-04-11 |
| Last Update Date | 2025-04-11 |