| NPI | 1811234099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEANDRA JELESE CONNER Owner 574-226-5213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2013-01-08 |
| Last Update Date | 2013-01-08 |