| NPI | 1225899388 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIE SWOBODA Practice Management Admin 812-206-1249 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2024-01-17 |
| Last Update Date | 2024-01-17 |