| NPI | 1558699801 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULA L TILLMAN Official 219-764-9400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251G00000X Hospice Care, Community Based |
| 385HR2050X Respite Care, Respite Care Camp | |
| Enumeration Date | 2009-11-25 |
| Last Update Date | 2009-11-25 |