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1346649688
HEATHER CARROLL
GRANGER, IN
NPI
1346649688
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Former Name
HEATHER WARRELL
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
3104A0625X Assisted Living Facility, Assisted Living, Mental Illness
Enumeration Date
2014-08-21
Last Update Date
2014-08-21
Business Address
-- HEATHER CARROLL COTA
430 E CLEVELAND RD
GRANGER, IN 46530-5624
Phone number: 574-271-3305
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Mailing Address
-- HEATHER CARROLL COTA
19839 DICE ST
SOUTH BEND, IN 46614-5513
Phone number: 574-217-2213
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