| NPI | 1700248564 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINA KINNALEY Program Administrator 260-444-3433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2016-03-22 |