| NPI | 1457772402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STANTON RISSER A CFO 260-266-9380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 283Q00000X Psychiatric Hospital |
| Additional Taxonomies | 276400000X Rehabilitation, Substance Use Disorder Unit |
| Enumeration Date | 2013-12-18 |
| Last Update Date | 2024-10-31 |