| NPI | 1891573713 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER DESMANGLES Mental Health Therapist 765-586-8155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-09-20 |
| Last Update Date | 2023-09-20 |