| NPI | 1568935278 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATIFAT A. OYEKOLA Owner 317-495-5173 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine Addiction Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 251E00000X Home Health | |
| Enumeration Date | 2019-01-04 |
| Last Update Date | 2021-03-08 |