| NPI | 1407061336 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID HALL CEO 219-763-8112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 1041C0700X Social Worker, Clinical | |
| 111N00000X Chiropractor | |
| 122300000X Dentist | |
| 152W00000X Optometrist | |
| 207Q00000X Family Medicine | |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism | |
| 207V00000X Obstetrics & Gynecology | |
| 208000000X Pediatrics | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 2085R0202X Radiology, Diagnostic Radiology | |
| 2085U0001X Radiology, Diagnostic Ultrasound | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LW0102X Nurse Practitioner, Women's Health | |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2020-09-22 |