| NPI | 1649649609 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA MINNICK Office Manager 812-828-7637 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IN 35001637A) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: IN 39001655A) |
| Enumeration Date | 2015-09-21 |
| Last Update Date | 2015-09-21 |