| NPI | 1619541091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELIA HILLARD Director 219-810-2407 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-05-19 |
| Last Update Date | 2022-12-06 |