| NPI | 1336454552 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARRELL GORDON CEO 765-939-4552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: IN 510144198 73834) |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: IN 525549198 73847) |
| Enumeration Date | 2010-08-12 |
| Last Update Date | 2010-08-12 |