| NPI | 1043518079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH MAVRELIS Sole Proprietor 219-730-1515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: IN 28060371A) |
| Enumeration Date | 2011-02-28 |
| Last Update Date | 2011-02-28 |