NPI | 1366042152 |
---|---|
Entity Type | Organization |
Authorized Contact | JILLIAN CARLSON MOON Owner 812-635-0138 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X |
Additional Taxonomies | 1041C0700X Social Worker, Clinical |
Enumeration Date | 2020-10-29 |
Last Update Date | 2023-04-25 |