| NPI | 1497135495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS NYSTROM CEO 317-319-3132 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2015-06-04 |
| Last Update Date | 2016-07-27 |