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Organization
JEFFERSON STREET HOLDINGS LLC
Active
Organization
JEFFERSON STREET HOLDINGS LLC
Active
Other names
The Little Green Door
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA GLASS (CEO)
(812) 501-0308
Entity
Organization
Contact information
Practice address
2235 E STATE ROAD 64, MARENGO, IN 47140-8725
(812) 501-0308
Mailing address
2235 E STATE ROAD 64, MARENGO, IN 47140-8725
(812) 501-0308
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/16/2026
Last updated
06/16/2026
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