| NPI | 1982054458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR OWEN PHILLIPS Counselor/Case Manager 216-351-3833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 120988) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: OH 120988) |
| Enumeration Date | 2016-06-15 |
| Last Update Date | 2017-12-28 |