| NPI | 1134572308 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA MARCELLA DAVIS PECK Owner President 317-919-8482 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: 87001460A) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: IN 39001382A) |
| 106H00000X Marriage & Family Therapist (Licence: IN 35001131A) | |
| Enumeration Date | 2016-07-22 |
| Last Update Date | 2016-07-22 |