| NPI | 1992581029 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TURISTA JACKSON President 317-993-2439 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QC1500X Clinic/Center Community Health | |
| 261QI0500X Clinic/Center Infusion Therapy | |
| 261QP0904X Clinic/Center Public Health, Federal | |
| 261QR0800X Clinic/Center Recovery Care | |
| Enumeration Date | 2023-09-05 |
| Last Update Date | 2023-09-05 |