| NPI | 1417355744 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTIE LACOLE COLEMAN-WILSON Director 317-319-1832 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2014-12-19 |
| Last Update Date | 2019-12-17 |