| NPI | 1790966810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCUS WIGUTOW President 219-769-5900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IN 01022387B) |
| Enumeration Date | 2007-11-16 |
| Last Update Date | 2007-11-19 |