| NPI | 1861950420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY THORKELSON President 330-632-0172 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| Enumeration Date | 2019-03-03 |
| Last Update Date | 2019-03-03 |