| NPI | 1609231927 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT KRUMWIED CEO 219-736-7183 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2015-12-31 |
| Last Update Date | 2016-07-01 |