| NPI | 1942039128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARREY EYONGHEROK CEO 937-329-7978 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YM0800X Counselor Mental Health | |
| 207Q00000X Family Medicine | |
| 207RA0401X Internal Medicine Addiction Medicine | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 261QP2300X Clinic/Center Primary Care | |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2024-07-29 |
| Last Update Date | 2024-07-29 |