| NPI | 1417546581 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARANDA HOUSER Ownership 574-747-7429 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-01-13 |
| Last Update Date | 2021-01-13 |