| NPI | 1821407503 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGG RICHARDS President 419-775-1771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OH S1050) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: OH 4741) |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: OH 892648) | |
| Enumeration Date | 2014-08-07 |
| Last Update Date | 2014-08-07 |