| NPI | 1205086246 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY OWENS GOODE President 574-231-1480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 34002903A) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IN 35000769A) |
| Enumeration Date | 2008-09-26 |
| Last Update Date | 2008-09-26 |