| NPI | 1154368512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARL DAVIS Board Member 317-882-5122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2024-09-17 |