| NPI | 1780357111 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LACI GIBONEY Executive Director 317-502-2231 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2021-07-30 |
| Last Update Date | 2021-07-30 |