| NPI | 1811260680 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNE T HOLLINGSWORTH President/CEO 219-395-1675 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IN 02001394A) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: MI 5101010753) |
| Enumeration Date | 2012-02-09 |
| Last Update Date | 2012-02-09 |