| NPI | 1700640729 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYANA CARPENTER Director 317-653-6665 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 177F00000X Lodging | |
| 251T00000X PACE Provider Organization | |
| 273Y00000X Rehabilitation Unit | |
| 174200000X Meals | |
| Enumeration Date | 2024-02-09 |
| Last Update Date | 2024-02-15 |