| NPI | 1609055490 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANZELLA MILLER Secretary 219-933-7111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC 71007216) |
| Enumeration Date | 2007-10-29 |
| Last Update Date | 2007-10-29 |