| NPI | 1811396567 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN W MOODY Owner 765-461-3033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34005092A) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IN 87000247A) |
| 1041C0700X Social Worker, Clinical (Licence: 34005092) | |
| Enumeration Date | 2014-08-19 |
| Last Update Date | 2022-07-21 |