| NPI | 1396458097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATOYA C EVANS CEO 317-983-9945 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2022-12-28 |
| Last Update Date | 2023-03-26 |