| NPI | 1417632456 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | BRITTANY FORD Therapist 317-473-2966  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health | 
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health | 
| Enumeration Date | 2023-06-19 | 
| Last Update Date | 2023-07-12 |