| NPI | 1912987371 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIARA S PEASE Clinical Billing Specialist 419-238-1695 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: OH 0393) |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2024-03-25 |