| NPI | 1306613302 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIN CORAM Lmft 317-965-0583 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 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 | 2023-12-08 |
| Last Update Date | 2024-02-28 |