| NPI | 1154847424 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS COLGROVE President 317-590-6139 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 39000854A) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IN 39002164A) |
| 101YP1600X Counselor, Pastoral (Licence: IN 33003053A) | |
| Enumeration Date | 2017-08-18 |
| Last Update Date | 2018-03-17 |