| NPI | 1295464147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON SHAKE CEO/Owner 317-474-2150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2022-06-07 |
| Last Update Date | 2023-08-24 |