| NPI | 1457109696 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY K LICHTENWALTER Owner 765-376-8099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-05-13 |
| Last Update Date | 2024-05-13 |