| NPI | 1538746961 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KALYANI GOPAL President 219-378-7161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2021-03-24 |