| NPI | 1205093960 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA A. ZIMMERMAN Owner 260-414-2690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IN 39001854A) |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2008-05-20 |