| NPI | 1770065153 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA WHITE CEO 812-208-3175 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: IN 390002582A) |
| Enumeration Date | 2018-09-03 |
| Last Update Date | 2019-01-18 |