| NPI | 1780055053 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVY RUFINA VOYNOVICH Clinical Supervisor 812-537-1668 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OH 081062) |
| Enumeration Date | 2015-10-13 |
| Last Update Date | 2015-10-13 |