| NPI | 1871030049 |
|---|---|
| Former Name | BROOKS MARIE CLINE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: OH 138428.meds-iv) |
| Enumeration Date | 2017-01-26 |
| Last Update Date | 2017-01-26 |