| NPI | 1982578902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEX HENDERSON Owner/Authorized Official 812-850-0619 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2025-10-02 |
| Last Update Date | 2025-10-03 |