| NPI | 1184781155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | C RICHARD DEHAVEN President & CEO 765-649-8161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2020-08-22 |