| NPI | 1255745287 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOLLY NEAR CAO 812-298-8888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 364S00000X Clinical Nurse Specialist | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2015-01-20 |