Organization
ADEC - STEVENS AVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA M SHIVELY (CEO)
(574) 848-7451
Entity
Organization
Contact information
Practice address
2001 STEVENS AVE, ELKHART, IN 46516-4013
(574) 848-7451
(574) 848-5917
Mailing address
19670 SR 120, BRISTOL, IN 46507-0398
(574) 848-7451
(574) 848-5917
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
2670I0015DE08
IN
Other
Enumeration date
04/13/2007
Last updated
08/22/2020
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