| NPI | 1255012506 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ALAN WEAVER CEO 219-241-5663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2023-07-28 |
| Last Update Date | 2024-04-19 |