| NPI | 1285105650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | R BRUCE SCHUCKER Program Director 765-807-0009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 177F00000X Lodging |
| Additional Taxonomies | 251B00000X Case Management |
| 251K00000X Public Health or Welfare | |
| Enumeration Date | 2018-12-11 |
| Last Update Date | 2018-12-11 |