| NPI | 1942986864 |
|---|---|
| Other Name | NONE |
| Entity Type | Organization |
| Authorized Contact | MICHELLE BAZIN-JOHNSON President 219-336-4866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2023-06-26 |
| Last Update Date | 2023-06-26 |