| NPI | 1235773664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT JAMES DUTKO Co Partner 219-730-2909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2019-10-29 |
| Last Update Date | 2019-10-29 |