| NPI | 1205434107 |
|---|---|
| Former Legal Business Name | HOPE CHEST TIKKUN OLAM CENTER LLC |
| Entity Type | Organization |
| Authorized Contact | TERESA N LONG Therapist 765-717-1403 |
| Organization Subpart ? | No |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2020-10-13 |
| Last Update Date | 2020-10-13 |