| NPI | 1811920697 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA K. MOORE President Board Of Directors 937-548-6842 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2013-04-25 |