| NPI | 1588158091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE MILLER Vice President 219-263-6204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 39002918A) |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2018-06-18 |