NPI | 1932732955 |
---|---|
Doing Business As | NEW LIFE CENTER - EDGEWATER FOR BALANCED LIVING |
Entity Type | Organization |
Authorized Contact | DANITA JOHNSON HUGHES CEO 219-885-4264 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Additional Taxonomies | 261QM2800X Clinic/Center, Methadone Clinic |
Enumeration Date | 2020-02-18 |
Last Update Date | 2020-02-18 |