| NPI | 1144722695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KURT A MOEHLE Member 317-450-1942 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IN 20040055A) |
| Enumeration Date | 2018-03-01 |
| Last Update Date | 2018-03-01 |