| NPI | 1851522965 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRINETTE CLARK President/Administrator 317-924-5804 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: IN 43858) |
| Additional Taxonomies | 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child (Licence: IN 43858) |
| Enumeration Date | 2009-08-06 |
| Last Update Date | 2009-08-06 |