| NPI | 1083463442 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEKO KOKEH Authorized Official 317-529-2372 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-05-16 |
| Last Update Date | 2024-07-30 |