| NPI | 1013494871 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARIELLE THIBODEAUX Owner/Clinician 317-775-8797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2018-07-25 |
| Last Update Date | 2020-01-15 |