| NPI | 1346791688 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETTY MAE GUZMAN Therapist 574-310-2410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IN 39002932A) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IN 39002932A) |
| Enumeration Date | 2016-10-21 |
| Last Update Date | 2017-01-24 |