| NPI | 1407341787 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEAN M NANOS Director/Owner 219-852-8558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IN 20043103A) |
| Enumeration Date | 2018-06-28 |
| Last Update Date | 2018-12-04 |