| NPI | 1275075475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINA M GRABER Owner 317-649-4311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X (Licence: IN 35001907A) |
| Enumeration Date | 2016-11-06 |
| Last Update Date | 2024-02-19 |