| NPI | 1104457951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEODORE GILBERT Clinical Director 219-730-3976 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2020-01-30 |
| Last Update Date | 2020-02-04 |