| NPI | 1821761081 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBIN GREEN Co 419-297-2049 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2021-07-26 |
| Last Update Date | 2021-09-14 |