| NPI | 1053034231 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUBEN KESHERIM Member 317-936-1240 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2022-09-22 |
| Last Update Date | 2024-10-31 |