| NPI | 1275986937 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA STICKEL Owner 317-417-5235 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 6401015514) |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2016-07-18 |