| NPI | 1265553606 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE A LUCKY Executive Director 574-289-9779 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: IN 320600000X) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2020-08-22 |