| NPI | 1437974425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK RICHARD LENTZ Owner 317-607-4355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-11-15 |
| Last Update Date | 2025-11-14 |