| NPI | 1205173952 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL NELSON GEORGE President 317-475-1389 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 34002279A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05000996A) |
| Enumeration Date | 2013-01-14 |
| Last Update Date | 2013-01-14 |