IEISHA MOFFETT

GARY, IN
NPI1366816084
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy320800000X Community Based Residential Treatment Facility, Mental Illness
Enumeration Date2015-11-18
Last Update Date2015-11-18
Business Address
IEISHA MOFFETT
1100 W 6TH AVE
GARY, IN 46402-1711
Phone number: 219-885-4264
Mailing Address
IEISHA MOFFETT
1100 W 6TH AVE
GARY, IN 46402-1711
Phone number: 219-885-4264