| NPI | 1861736456 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH BRIGGS Program Director 219-873-2082 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0000X Family Medicine, Adolescent Medicine |
| Enumeration Date | 2012-11-20 |
| Last Update Date | 2012-11-20 |