NPI | 1881093706 |
---|---|
Entity Type | Organization |
Authorized Contact | LISA BRADLEY WERTH Owner / Clinical Director 765-427-5758 |
Organization Subpart ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34004717A) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IN 87000637A) |
Enumeration Date | 2014-08-15 |
Last Update Date | 2014-08-15 |