| NPI | 1821548777 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY JAMIA JACOBSEN President 317-282-3088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IN 87000971A) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IN 34002287A) |
| Enumeration Date | 2016-10-04 |
| Last Update Date | 2024-05-31 |