| NPI | 1871938720 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATILDA JOHNSON Owner 317-574-9009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child (Licence: LA 1477770) |
| Enumeration Date | 2013-05-06 |
| Last Update Date | 2013-05-06 |