| NPI | 1144190992 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LASHAYIA HOLMAN Lcsw 219-214-6889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2025-11-07 |
| Last Update Date | 2026-01-29 |