| NPI | 1902272578 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL S BULLOCK Executive Director 330-253-6689 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: OH 390) |
| Enumeration Date | 2015-08-18 |
| Last Update Date | 2015-08-18 |