# ANTHONY ADAMS HOUSE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255087342
- **Authorized official:** CANDICE NELSON (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (219) 214-6505

## Contact information

- **Practice address:** 2601 E MICHIGAN BLVD STE B, MICHIGAN CITY, IN 46360-5369
- **Practice address phone:** (219) 214-6505
- **Mailing address:** PO BOX 262, MICHIGAN CITY, IN 46361-0262
- **Mailing address phone:** (219) 214-6505

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | NULL | Yes |
| 252Y00000X | Early Intervention Provider Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | — |
| 261QF0050X | Non-Surgical Family Planning Clinic/Center | — | NULL | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | — |
| 261QS1000X | Student Health Clinic/Center | — | NULL | — |
| 343900000X | Non-emergency Medical Transport (VAN) | — | NULL | — |

## Other

- **Enumeration date:** 02/27/2022
- **Last updated:** 02/27/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000001 | N/A | — |