| NPI | 1699368795 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELYN ELAINE POWELL Director 317-371-1122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2021-02-19 |
| Last Update Date | 2021-02-19 |