| NPI | 1609326313 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD EVERSON Medical Director 812-256-4686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IN 101ya0y00x/counselor) |
| Enumeration Date | 2016-10-05 |
| Last Update Date | 2016-10-05 |