| NPI | 1407072762 |
|---|---|
| Doing Business As | LDS FAMILY SERVICES INDIANA AGENCY |
| Entity Type | Organization |
| Authorized Contact | MATTHEW J WILSON Counseling Supervisor 317-522-0224 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IN 169096933) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2009-09-14 |