| NPI | 1740856483 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL CORYEA Owner 812-583-6540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 363L00000X Nurse Practitioner | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2021-06-02 |
| Last Update Date | 2024-02-29 |