| NPI | 1912654526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE COLLEEN CLEVELAND-MOORE Owner/Clinical Director 317-413-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2022-03-03 |
| Last Update Date | 2022-03-03 |