| NPI | 1124016050 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY D CROCKETT Financial Officer 317-587-0505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 103TC0700X Psychologist, Clinical | |
| 1041C0700X Social Worker, Clinical | |
| 163WP0809X Registered Nurse, Psych/Mental Health, Adult | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 364SP0807X Clinical Nurse Specialist, Psych/Mental Health, Child & Adolescent | |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2024-11-14 |