| NPI | 1154504462 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA DENNIE Owner 219-947-4758 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IN 34005349A) |
| Enumeration Date | 2007-12-10 |
| Last Update Date | 2007-12-10 |