NPI | 1437421435 |
---|---|
Entity Type | Organization |
Authorized Contact | ANTHONY LOUIS BERARDI President 574-232-1405 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IN 20010290A) |
Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MI 6301006300) |
Enumeration Date | 2012-02-07 |
Last Update Date | 2016-08-04 |