| NPI | 1114985181 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MA LUISA SUMABAT Secretary Treasurer 260-824-9265 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: IN 50004131) |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2017-05-22 |