| NPI | 1134690589 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOSHIA FIFER CEO 317-619-5641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2018-12-11 |
| Last Update Date | 2023-08-04 |