| NPI | 1497055537 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLESZETTA LEWIS LEWIS Executive Director 765-455-2300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center Adult Day Care |
| Enumeration Date | 2010-10-22 |
| Last Update Date | 2010-10-22 |