| NPI | 1588191191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENEVA O WESLEY C.E.O. 219-576-2662 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IN 33005022A) |
| Enumeration Date | 2017-05-12 |
| Last Update Date | 2017-05-12 |