| NPI | 1760988745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH ANN SIEJA Owner 567-277-0484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: OH E1000368) |
| Enumeration Date | 2018-03-30 |
| Last Update Date | 2018-04-05 |