Willowglen Academy - Indiana

NPI 1073788113 - Residential Treatment Facility, Emotionally Disturbed Children - 322D00000X

NPI Details
NPI 1073788113
Enumeration Date 04/29/2008
Last Updated 06/17/2008
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name DWAYNE W DWAYNE
Position EXECUTIVE DIRECTOR
Phone (219) 886-1320
Fax
Practice Location
308 E 21ST AVE
GARY IN, 46407-2618, US
Phone (219) 886-1320
Fax
Business Location
308 E 21ST AVE
GARY IN, 46407-2618, US
Phone (219) 886-1320
Fax
Toxanomy
Taxonomy Code 322D00000X
License State Indiana
License Number 33456
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According to our database, Willowglen Academy - Indiana NPI is 1073788113, taxonomy code is 322D00000X and license number is 33456, license state is located at Indiana. Willowglen Academy - Indiana physically located at 308 E 21st Ave, Gary IN, 46407-2618. NPI Number 1033115704 has the healthcare provider type.

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1073788113 NPI number is provided on an as is basis without warranty of any kind. 1073788113 is maintained by the National Plan & Provider Enumeration System. The contents of Willowglen Academy - Indiana are for informational purposes only.