# IHC WIC PROGRAM AT KOKOMO

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

## Provider details

- **NPI number:** 1710191788
- **Authorized official:** LYNN CLOTHIER (CEO)
- **Authorized official phone:** (317) 576-1335

## Contact information

- **Practice address:** 3118 S LAFOUNTAIN ST, KOKOMO, IN 46902-3710
- **Practice address phone:** (765) 864-4160
- **Practice address fax:** (765) 864-4166
- **Mailing address:** 8003 CASTLEWAY DRIVE, INDIANAPOLIS, IN 46902
- **Mailing address phone:** (317) 576-1335
- **Mailing address fax:** (317) 576-1339

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 05/09/2007
- **Last updated:** 08/22/2020