| NPI | 1689627598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY K. IDSTEIN Executive Vice President, Finance 219-531-3500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X (Licence: IN 418-0-CMHC) |
| Additional Taxonomies | 261QM0801X (Licence: IN 418-0-ASR) |
| 261QM0801X (Licence: IN 418-0-GAM) | |
| 261QM0801X (Licence: IN 418-0-SMI) | |
| 261QM2800X Clinic/Center, Methadone Clinic (Licence: IN 61100664B) | |
| 261QM0801X (Licence: IN 418-14-9-14) | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2023-06-16 |