| NPI | 1164986055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA ELENA ZARANDONA Mental Health Counselor 574-999-4544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 251S00000X |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2019-01-25 |
| Last Update Date | 2019-01-25 |