| NPI | 1154381739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DWAYNE O MITCHELL Chief Executive Officer 219-392-4900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2011-03-10 |