| NPI | 1568867026 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEILA COLLEEN WILLIAMSON Executive/Clinical Director 317-926-5463 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: IN 1681-0-ASO) |
| Enumeration Date | 2014-10-27 |
| Last Update Date | 2014-10-27 |