| NPI | 1134276884 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAN L OLIVER Business Director 765-289-5437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2020-08-22 |