| NPI | 1700432341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LETTY LAMBOY Credentialing Manager 317-291-1967 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional | |
| 104100000X Social Worker | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2019-08-09 |
| Last Update Date | 2026-08-13 |