| NPI | 1659415214 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIRLEY HAWKINS Executive Director 219-882-5565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 207Q00000X Family Medicine | |
| 207VX0000X Obstetrics & Gynecology Obstetrics | |
| 208000000X Pediatrics | |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2020-08-22 |