# WILLOWGLEN ACADEMY - INDIANA

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PHOENIX CARE SYSTEMS, INC.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1417227984
- **Legal business name:** PHOENIX CARE SYSTEMS, INC.
- **Authorized official:** MS. LORENE CAMERON (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (219) 886-1320

## Contact information

- **Practice address:** 2301 JEFFERSON ST, GARY, IN 46407-3043
- **Practice address phone:** (219) 886-2660
- **Practice address fax:** (219) 886-1319
- **Mailing address:** 2301 JEFFERSON ST, GARY, IN 46407-3043
- **Mailing address phone:** (219) 886-2660
- **Mailing address fax:** (219) 886-1319

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | — | Yes |

## Other

- **Enumeration date:** 12/30/2011
- **Last updated:** 12/30/2011