| NPI | 1184140253 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER VICKERS CEO/Partner 219-525-4577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IN 87001213A) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2017-08-20 |
| Last Update Date | 2022-07-21 |