| NPI | 1801788872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLUSADE O FAKOLADE Owner/CEO 317-457-7329 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-07-16 |
| Last Update Date | 2025-07-18 |