| NPI | 1639889561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID KENNEY Owner 317-361-2645 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| 385HR2055X Respite Care, Respite Care, Mental Illness, Child | |
| 251B00000X Case Management | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2022-12-01 |
| Last Update Date | 2022-12-01 |