| NPI | 1063167070 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANISIA CROWDER Owner 317-941-6106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-02-17 |
| Last Update Date | 2022-02-17 |