| NPI | 1396286803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY WILMA HAGE Clinical Director 317-437-5104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 3400734A) |
| Enumeration Date | 2017-03-16 |
| Last Update Date | 2024-03-22 |