| NPI | 1891917449 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLINT BOLSER CEO 574-289-4831 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 251S00000X | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2012-08-01 |