| NPI | 1760066476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW NATHANIEL ISSAC OLIVER Chief Executive Officer 765-860-8365 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251B00000X Case Management |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2021-05-09 |
| Last Update Date | 2022-05-26 |