Organization
ANTHONY ADAMS HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CANDICE NELSON (EXECUTIVE DIRECTOR)
(219) 214-6505
Entity
Organization
Contact information
Practice address
2601 E MICHIGAN BLVD STE B, MICHIGAN CITY, IN 46360-5369
(219) 214-6505
Mailing address
PO BOX 262, MICHIGAN CITY, IN 46361-0262
(219) 214-6505
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QF0050X
Non-Surgical Family Planning Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QS1000X
Student Health Clinic/Center
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001
N/A
—
Enumeration date
02/27/2022
Last updated
02/27/2022
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