Organization
KEENER CIVIL TOWNSHIP JASPER COUNTY TTEE
Active
Other names
Keener Township Ambulance/ EMS
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANA MARIE HABERLIN (KEENER TOWNSHIP TRUSTEE)
(219) 987-7825
Entity
Organization
Contact information
Practice address
708 15TH ST SE, DEMOTTE, IN 46310
(219) 987-2021
Mailing address
16900 N US HIGHWAY 231, DEMOTTE, IN 46310-8369
(219) 987-7825
(219) 987-7826
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
0034
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000191760
ATHEM
IN
05
—
20024750
—
IN
Enumeration date
07/09/2006
Last updated
08/30/2018
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