Organization
FULL GOSPEL
Active
Organization
FULL GOSPEL
Active
Other names
BUTTERCUP
Organization subpart
No
Provider details
NPI number
Authorized official
ANTOINETTE CUNDIFF (PRESIDENT)
(219) 281-9481
Entity
Organization
Contact information
Practice address
857 PROSPECT ST, VALPARAISO, IN 46385-4552
(219) 281-9481
Mailing address
2701 WILLOWCREEK RD UNIT 1841, PORTAGE, IN 46368-7476
(219) 281-9481
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
05/17/2023
Last updated
05/17/2023
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