| NPI | 1881065712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOM IVANY CEO 330-259-8813 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 208D00000X General Practice | |
| Enumeration Date | 2015-10-19 |
| Last Update Date | 2023-12-11 |