| NPI | 1427345792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY I WRIGHT Owner 260-316-0979 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IN 39001897A) |
| Enumeration Date | 2011-07-07 |
| Last Update Date | 2011-07-07 |