| NPI | 1053964866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA D PROBST Owner 260-241-5867 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-07-20 |
| Last Update Date | 2019-07-20 |