| NPI | 1407707763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN THOMAS Director 317-557-9090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2026-02-04 |
| Last Update Date | 2026-02-04 |