NPI | 1801507165 |
---|---|
Entity Type | Organization |
Authorized Contact | LISA SULLIVAN Credentialing Specialist 440-453-0754 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2022-12-07 |
Last Update Date | 2022-12-07 |