| NPI | 1891262762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANET SEABROOK CEO 219-880-1190 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2018-10-30 |
| Last Update Date | 2018-10-30 |