| NPI | 1164925772 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL G HAGEDORN Managing Member 812-499-7950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor Mental Health | |
| 1041C0700X Social Worker Clinical | |
| 261Q00000X Clinic/Center | |
| 364S00000X Clinical Nurse Specialist | |
| 364SF0001X Clinical Nurse Specialist Family Health | |
| Enumeration Date | 2018-03-10 |
| Last Update Date | 2022-06-29 |