| NPI | 1245680057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIVIAN L IRETON Therapist 812-449-9355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IN 34006251A) |
| Enumeration Date | 2016-06-13 |
| Last Update Date | 2016-06-13 |