| NPI | 1124512405 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AQUANATTE JACKSON CEO 219-292-8394 |
| Organization Subpart ? | No |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TC1900X Psychologist, Counseling | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2018-06-19 |
| Last Update Date | 2023-02-21 |