| NPI | 1922654276 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISITNE JORDAN Clinical Director 216-906-1117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Enumeration Date | 2019-08-13 |
| Last Update Date | 2019-08-13 |