| NPI | 1194517094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGAN TATLOCK Administrator 812-379-2319 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2025-05-19 |
| Last Update Date | 2025-05-28 |