| NPI | 1891325551 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA GOULDING Billing Rep 419-565-7298 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-01-22 |
| Last Update Date | 2020-01-30 |