Organization
HOME-BASED BEHAVIORAL SOLUTIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF KAZMIERCZAK (CEO PRESIDENT)
(414) 861-1688
Entity
Organization
Contact information
Practice address
7863 BROADWAY, 220, MERRILLVILLE, IN 46410-5553
(219) 795-1275
(219) 795-1277
Mailing address
7863 BROADWAY, SUITE 220, MERRILLVILLE, IN 46410-5553
(219) 795-1275
(219) 795-1277
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
03/07/2013
Last updated
03/08/2013
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