| NPI | 1265068084 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SASHA KENDALL Owner 812-480-0778 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-03-13 |
| Last Update Date | 2020-03-24 |