| NPI | 1043375934 |
|---|---|
| Doing Business As | IMMANUEL FAMILY HEALTH CENTER |
| Entity Type | Organization |
| Authorized Contact | KANAYO K ODELUGA Owner/Md 219-397-6000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261Q00000X |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2019-06-18 |