| NPI | 1588167860 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY KATHLEEN AGUILAR Co Owner 260-740-4366 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IN 34006941A) |
| Enumeration Date | 2018-03-13 |
| Last Update Date | 2021-09-13 |