| NPI | 1841438538 |
|---|---|
| Other Name | SANDUSKY AVENUE |
| Entity Type | Organization |
| Authorized Contact | THAN JOHNSON Chief Executive Officer 937-653-1320 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2009-02-03 |
| Last Update Date | 2009-02-03 |