| NPI | 1528134897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNITA MARION SCULLY Executive Director 219-879-7895 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2020-08-22 |