| NPI | 1891915872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE DOUGLASS President 765-659-5547 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34003984A) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2020-08-22 |