| NPI | 1982695706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY L RIGGER CEO 937-399-9500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| Enumeration Date | 2005-11-01 |
| Last Update Date | 2021-05-11 |