| NPI | 1417250606 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACIELA E HERNANDEZ President 219-937-2929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IN 011029949) |
| Enumeration Date | 2010-12-10 |
| Last Update Date | 2015-06-01 |