| NPI | 1003755927 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA FOSTER Member 317-622-9141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) | |
| 2083A0300X Preventive Medicine, Addiction Medicine | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2026-03-26 |
| Last Update Date | 2026-03-26 |