| NPI | 1366990764 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEIDRA J LOYD Director 317-513-9404 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IN 20042331A) |
| Enumeration Date | 2016-09-14 |
| Last Update Date | 2016-09-14 |