| NPI | 1871325621 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JARVIS MACK Owner 330-356-4420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0005X Psychiatry & Neurology Neurodevelopmental Disabilities |
| Enumeration Date | 2024-08-19 |
| Last Update Date | 2024-08-19 |