| NPI | 1649723628 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK DALE BUCHANAN Executive Director 574-360-8409 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251V00000X Voluntary or Charitable |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2016-07-26 |
| Last Update Date | 2016-07-26 |