| NPI | 1780480822 |
|---|---|
| Former Legal Business Name | AQUARIAN MINISTRY LTD SPIRITUALIST CHURCH |
| Entity Type | Organization |
| Authorized Contact | TERESE A POLING Doctor Of Medicine 317-907-4198 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2025-02-20 |
| Last Update Date | 2025-02-20 |