| NPI | 1578566915 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK DRANGER Office Manager 219-548-8727 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2011-11-16 |