| NPI | 1386889459 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA S VICKERY Owner 219-671-0771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: IN 200898230A) |
| Enumeration Date | 2008-12-03 |
| Last Update Date | 2008-12-03 |