| NPI | 1982438719 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANELLE L LAWSON Executive Administrator 317-883-7573 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YP1600X Counselor Pastoral |
| 171400000X | |
| 175T00000X Peer Specialist | |
| Enumeration Date | 2024-08-26 |
| Last Update Date | 2024-08-26 |