| NPI | 1851017636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM CUSNER Owner 740-338-2273 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Enumeration Date | 2022-10-13 |
| Last Update Date | 2022-11-21 |