| NPI | 1083906531 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA DENIESE BUCKNER Owner, Director 317-259-7122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IN 34002010A) |
| Enumeration Date | 2011-05-03 |
| Last Update Date | 2011-05-03 |