| NPI | 1780188045 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY RICKE Owner 317-504-9252 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: IN 01069546A) |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2018-03-21 |