NPI | 1184005589 |
---|---|
Entity Type | Organization |
Authorized Contact | TABATHA CREASBAUM Owner 219-588-3540 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IN 39002363A) |
Enumeration Date | 2015-06-11 |
Last Update Date | 2015-06-11 |