| NPI | 1811528599 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY M LOCKE Owner/Provider 317-544-9445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2020-01-30 |
| Last Update Date | 2025-08-19 |