| NPI | 1790584126 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MADELINE J GERIG SHELLY Therapist 574-309-2196 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-03-10 |
| Last Update Date | 2025-03-10 |