| NPI | 1932732955 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANITA JOHNSON HUGHES CEO 219-885-4264 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QM2800X Clinic/Center Methadone |
| Enumeration Date | 2020-02-18 |
| Last Update Date | 2020-02-18 |