| NPI | 1275043069 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENAE CLARK-WEATHERLY Therapist 317-222-9704 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management (Licence: IN 99064493A) |
| Additional Taxonomies | 251B00000X Case Management |
| 251S00000X (Licence: IN 99074128A) | |
| Enumeration Date | 2017-10-05 |
| Last Update Date | 2018-06-16 |