NPI | 1174746341 |
---|---|
Entity Type | Organization |
Authorized Contact | HERBERT GRULKE CEO 219-662-1905 |
Organization Subpart ? | No |
Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
Additional Taxonomies | 251S00000X Community/Behavioral Health |
Enumeration Date | 2007-04-10 |
Last Update Date | 2025-09-11 |