| NPI | 1982585261 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK JOSHUA LEE CEO 419-290-4722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-09-11 |
| Last Update Date | 2025-09-11 |