| NPI | 1376691154 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA J CLANTON Contracts Manager 574-283-1107 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 283Q00000X Psychiatric Hospital (Licence: IN 406-1-PIP) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IN 406-1-PIP) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2010-04-07 |