| NPI | 1518338664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA GINGERICH Occupational Therapist 317-690-6571 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: IN 31004338A) |
| Enumeration Date | 2015-10-15 |
| Last Update Date | 2015-10-15 |