| NPI | 1669540951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | C RICHARD DEHAVEN Vice President & CEO 765-641-8281 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2006-12-03 |
| Last Update Date | 2008-06-24 |