| NPI | 1902205289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH JOHNSON Authorized Official 440-843-5615 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OH E.0004212) |
| Enumeration Date | 2014-08-22 |
| Last Update Date | 2014-08-22 |