| NPI | 1902242647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY J MALONE CEO/President 765-641-0255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 20042205A) |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2013-05-21 |