| NPI | 1669967428 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACI LYNN GIBSON President 317-919-1122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2018-06-25 |