| NPI | 1194274852 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELINE RAE SCHULLLER Program Director 219-750-9202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 1194719435) |
| Additional Taxonomies | 104100000X Social Worker (Licence: IN 33007638A) |
| Enumeration Date | 2016-09-22 |
| Last Update Date | 2016-09-22 |