| NPI | 1407108079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLEOTIS WHITE CEO 219-801-1789 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IN 1636-0-ASO) |
| Enumeration Date | 2012-10-08 |
| Last Update Date | 2012-10-08 |