FRED LEWIS

GARY, IN
NPI1730568247
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy320800000X Community Based Residential Treatment Facility, Mental Illness
Enumeration Date2015-05-29
Last Update Date2015-05-29
Business Address
-- FRED LEWIS
1100 W 6TH AVE
GARY, IN 46402-1711
Phone number: 219-885-4264
Mailing Address
-- FRED LEWIS
1100 W 6TH AVE
GARY, IN 46402-1711
Phone number: 219-885-4264