| NPI | 1467104067 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL D FRY Chairman Of The Board Of Directors 765-242-5790 |
| Organization Subpart ? | No |
| Primary Taxonomy | 276400000X Rehabilitation, Substance Use Disorder Unit |
| Enumeration Date | 2022-01-25 |
| Last Update Date | 2022-01-25 |