| NPI | 1518639020 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER J MULLETT Owner/ Executive Director 765-607-4622 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2021-10-03 |
| Last Update Date | 2021-10-03 |