| NPI | 1225289242 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BUCK J BLACK President 765-807-6778 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IN 34005584A) |
| Enumeration Date | 2008-10-08 |
| Last Update Date | 2023-08-06 |