| NPI | 1689629990 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS L. GILLIOM CEO 765-446-6535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2023-03-29 |