| NPI | 1316446628 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLA MOSES Owner 765-491-6515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: IN 71002822A) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2018-02-02 |
| Last Update Date | 2018-02-02 |