| NPI | 1750855664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY LYNN REEVAS Owner 574-904-8552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-01-14 |
| Last Update Date | 2019-02-03 |