Adec-bridlewood

NPI 1043434624 - Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities - 320600000X

NPI Details
NPI 1043434624
Enumeration Date 04/12/2007
Last Updated 07/09/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name PAULA M PAULA
Position CEO
Phone (574) 848-7451
Fax (574) 818-5917
Practice Location
58808 ST MARYS LN
GOSHEN IN, 46528-7623, US
Phone (574) 848-7451
Fax (574) 818-5917
Business Location
19670 SR 120
BRISTOL IN, 46507-0398, US
Phone (574) 848-7451
Fax (574) 848-5917
Toxanomy
Taxonomy Code 320600000X
License State Indiana
License Number 2670I0017JN08
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According to our database, Adec-bridlewood NPI is 1043434624, taxonomy code is 320600000X and license number is 2670I0017JN08, license state is located at Indiana. Adec-bridlewood physically located at 58808 St Marys Ln, Goshen IN, 46528-7623. NPI Number 1033115704 has the healthcare provider type.

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1043434624 NPI number is provided on an as is basis without warranty of any kind. 1043434624 is maintained by the National Plan & Provider Enumeration System. The contents of Adec-bridlewood are for informational purposes only.