| NPI | 1477170439 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MORRIS LONG Owner 317-870-1396 |
| Organization Subpart ? | No |
| Primary Taxonomy | 283Q00000X Psychiatric Hospital |
| Additional Taxonomies | 2084P0805X |
| Enumeration Date | 2020-06-25 |
| Last Update Date | 2023-06-13 |