| NPI | 1003205998 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINA NICOLE STAPLETON Counselor 765-243-9416 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IN 39002095A) |
| Enumeration Date | 2015-01-14 |
| Last Update Date | 2015-01-14 |