| NPI | 1083160584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BECKY JACKOWSKI Secretary 219-808-0793 |
| Organization Subpart ? | No |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IN 3300867A) |
| Enumeration Date | 2016-08-25 |
| Last Update Date | 2018-02-06 |