| NPI | 1194745059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | J. MARK KILLMER Executive Director 219-923-8110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 34003134A) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2020-08-22 |