| NPI | 1053370270 |
|---|---|
| Doing Business As | FAYETTE REGIONAL CARE PAVILLION |
| Entity Type | Organization |
| Authorized Contact | RANDALL WHITE CEO 765-827-7987 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: IN 7352421900926) |
| Enumeration Date | 2006-03-18 |
| Last Update Date | 2016-03-23 |