Organization
WILLOWGLEN ACADEMY - INDIANA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DWAYNE WARREN MUELLER RN (EXECUTIVE DIRECTOR)
(219) 886-1320
Entity
Organization
Contact information
Practice address
308 E 21ST AVE, GARY, IN 46407-2618
(219) 886-1320
(219) 886-1319
Mailing address
308 E 21ST AVE, GARY, IN 46407-2618
(219) 886-1320
(219) 886-1319
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
33456
IN
Other
Enumeration date
03/13/2007
Last updated
08/22/2020
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