| NPI | 1760247001 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY LEE RUSSELL Owner/Director 419-528-8008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 225C00000X Rehabilitation Counselor | |
| Enumeration Date | 2024-02-15 |
| Last Update Date | 2024-02-15 |