Organization
SEQUEL TSI OF INDIANA, LLC
Active
Other names
Englishton Park
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN STUPAK (PRESIDENT)
(267) 419-8913
Entity
Organization
Contact information
Practice address
2426 S PARKER LN, LEXINGTON, IN 47138-8561
(812) 889-3992
(812) 889-3990
Mailing address
2426 S PARKER LN, LEXINGTON, IN 47138-8561
(812) 889-3992
(812) 889-3990
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/29/2009
Last updated
12/29/2009
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