| NPI | 1538451695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SERQUITTO NYCOLE CORNNER President/CEO 317-252-3990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2011-05-09 |
| Last Update Date | 2011-05-09 |