| NPI | 1164181566 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELIA HALL Manager 317-939-3049 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2021-12-13 |
| Last Update Date | 2024-06-19 |