| NPI | 1447638903 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA PHALEN Director 219-554-4548 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 99067018A) |
| Enumeration Date | 2015-05-15 |
| Last Update Date | 2023-02-13 |