| NPI | 1598263469 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRISHEN MARIE LEWIS-WEIR Behavioral Health Therapist 317-459-0676 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: IN 34006593A) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: IN 34006593A) |
| Enumeration Date | 2018-01-25 |
| Last Update Date | 2018-01-25 |