| NPI | 1356352991 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT A EDWARDS President 765-854-6010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2010-12-08 |