| NPI | 1134519283 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN KOCHERT Physician 765-446-5055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: IN 01031275A) |
| Enumeration Date | 2015-01-28 |
| Last Update Date | 2015-01-28 |