| NPI | 1053665158 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL KUCZORA CEO 765-662-3971 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IN 34006590A) |
| Enumeration Date | 2012-10-29 |
| Last Update Date | 2012-10-29 |