| NPI | 1023739067 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE MICHELLE TILT Owner, CEO, Clinical Director 765-630-7222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical | |
| 133V00000X Dietitian, Registered | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2022-09-08 |
| Last Update Date | 2022-09-08 |