| NPI | 1316774326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALECIA NICOLE TOLES CEO 317-403-9093 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Enumeration Date | 2024-09-16 |
| Last Update Date | 2024-09-16 |