| NPI | 1821747098 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWINA BUTTS Owner 419-902-9402 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2022-03-23 |
| Last Update Date | 2023-11-27 |