| NPI | 1508232190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERI LYNN WIMBERLY-BROWN Owner 317-525-0226 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IN 87001136A) |
| Enumeration Date | 2015-08-18 |
| Last Update Date | 2015-08-18 |