| NPI | 1982575288 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANEE M CARLILE Owner 574-360-2695 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-09-17 |
| Last Update Date | 2025-09-17 |