| NPI | 1760537757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEDEA LAUREL WOODS President 812-594-2868 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IN 20041772A) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2020-08-22 |