| NPI | 1902547136 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHVONNE WATSON CEO 317-213-7975 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2022-04-03 |
| Last Update Date | 2022-04-03 |