| NPI | 1174746341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HERBERT GRULKE CEO 219-662-1905 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2020-08-22 |