| NPI | 1760889570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY ELLIS Administrator 765-628-0605 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: IN 32002754A) |
| Enumeration Date | 2014-11-21 |
| Last Update Date | 2014-11-21 |