| NPI | 1154607547 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY KATHLEEN FROMM Owner 219-844-7152 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IN 34003651A) |
| Enumeration Date | 2011-10-29 |
| Last Update Date | 2011-10-29 |