| NPI | 1861065252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE LANAE WHITE Wner 216-340-7484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Enumeration Date | 2021-07-22 |
| Last Update Date | 2021-07-22 |