| NPI | 1275126955 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLINKA LASHAE CLARK Executive Director 260-418-6080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 251S00000X |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2021-02-14 |
| Last Update Date | 2021-02-15 |