| NPI | 1326290164 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZANNE BONAVENTURA-KRISCHKE Owner 219-663-6353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IN 33004882A) |
| Enumeration Date | 2008-10-10 |
| Last Update Date | 2022-06-23 |