| NPI | 1811004526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE VON BARGEN Administrator 260-471-8033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 39000434A) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: IN 35001315A) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2020-08-22 |