| NPI | 1487050373 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PENNY ENDRES Insurance Specialist 317-858-8630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IN 31005770A) |
| Enumeration Date | 2014-11-05 |
| Last Update Date | 2014-11-05 |