| NPI | 1578685160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN G. DAVIS Program Supervisor 812-282-8248 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: IN 33428 10-900845) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2020-08-22 |