| NPI | 1881341717 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRAE SALMOND Owner 317-775-8880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2022-03-10 |
| Last Update Date | 2023-05-23 |