| NPI | 1558186700 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | JILLIAN BEYKE Owner 317-662-0227  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | 
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency | 
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2024-11-21 | 
| Last Update Date | 2025-03-04 |