| NPI | 1790558120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL WEAVER Owner 937-718-1610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2023-11-07 |
| Last Update Date | 2024-03-14 |