| NPI | 1275401747 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATINA ANDREA WADE CEO 317-964-1010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2025-10-27 |
| Last Update Date | 2025-10-27 |