| NPI | 1700177003 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY R. EADS Owner 812-333-4379 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IN 34005321A) |
| Enumeration Date | 2011-04-21 |
| Last Update Date | 2011-04-21 |