| NPI | 1578109344 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID T NELLIS Licensed Clinical Social Worker 812-774-3970 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2019-11-26 |
| Last Update Date | 2019-11-26 |