| NPI | 1245724566 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY GATES Manager 765-254-2685 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: IN 422-046) |
| Enumeration Date | 2018-06-20 |
| Last Update Date | 2018-06-20 |