| NPI | 1356838130 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH LOCKE Member/Owner 574-370-8095 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34006736A) |
| Enumeration Date | 2018-04-17 |
| Last Update Date | 2018-04-20 |