| NPI | 1992431043 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA OATES Owner 330-502-2731 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-07-29 |
| Last Update Date | 2023-07-27 |