| NPI | 1982714226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBI JACOBS Office Manager 937-335-4543 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 1636) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2012-05-02 |