| NPI | 1780893644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL SUE PAHANISH Owner 330-698-2970 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: OH 8510490) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2020-08-22 |