| NPI | 1205315033 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA STANTON Owner 574-220-7084 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health (Licence: IN 71006282A) |
| Additional Taxonomies | 3104A0625X Assisted Living Facility Assisted Living, Mental Illness (Licence: IN 71016282A) |
| 310500000X Intermediate Care Facility, Mental Illness (Licence: IN 71016282A) | |
| 314000000X Skilled Nursing Facility (Licence: IN 71016282A) | |
| Enumeration Date | 2018-08-13 |
| Last Update Date | 2018-08-22 |