| NPI | 1689154742 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCIA KOELNDORFER Owner 574-387-5598 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-08-17 |
| Last Update Date | 2018-08-17 |