| NPI | 1063782803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES BRADLEY TEAGUE President 317-849-9509 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IN 20040735) |
| Enumeration Date | 2012-01-11 |
| Last Update Date | 2012-01-11 |