| NPI | 1124385323 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD JOSEPH MICHAEL Medical Director 574-254-0103 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IN 01034859) |
| Enumeration Date | 2012-04-12 |
| Last Update Date | 2012-04-12 |