NPI | 1750447611 |
---|---|
Entity Type | Organization |
Authorized Contact | JANICE E GABE President And Owner 317-465-9688 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: IN 34001287A) |
Enumeration Date | 2006-12-28 |
Last Update Date | 2020-08-22 |