| NPI | 1245070846 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL BANNING Owner 219-775-4271 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2024-05-30 |
| Last Update Date | 2024-08-30 |