| NPI | 1811528599 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY M LOCKE Owner 317-544-9445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2020-01-30 |
| Last Update Date | 2023-06-27 |