| NPI | 1588705784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUNETTE LASHAUN LOTT Director Accts. Receivables 219-885-4264 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2019-01-11 |