| NPI | 1881063196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENISHA RENEE PEDEN Therapist 219-240-8615 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2015-09-16 |
| Last Update Date | 2015-09-16 |