| NPI | 1801419031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHERINE LYNN RAY Licensed Clinical Social Worker 317-575-0500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-05-21 |
| Last Update Date | 2020-05-21 |