| NPI | 1790339703 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAMICAH BETTS Intake Coordinator 937-204-7506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 251S00000X |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2019-07-29 |
| Last Update Date | 2019-07-29 |