| NPI | 1346535754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD NICOLET Owner 260-436-5815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 39001898A) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IN 87000094A) |
| Enumeration Date | 2011-06-14 |
| Last Update Date | 2011-06-14 |