| NPI | 1992755490 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT RIGGS CFO 765-288-1928 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 283Q00000X Psychiatric Hospital |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2019-06-14 |