| NPI | 1578235735 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA JOHNSON Chief Executive Officer 219-703-2585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2021-10-05 |
| Last Update Date | 2021-10-05 |