| NPI | 1952332298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANET SEABROOK Executive Director 219-880-1190 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QC1500X Clinic/Center Community Health |
| Additional Taxonomies | 261QC1500X Clinic/Center Community Health |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2011-12-21 |