| NPI | 1346516499 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID CHRISTESON Executive Director 812-426-6626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: IN A1221) |
| Enumeration Date | 2012-03-22 |
| Last Update Date | 2012-03-22 |