| NPI | 1669867016 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK O'CONNELL Owner 219-465-8794 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 39002253A) |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2015-04-02 |