Organization
GIBAULT, INC. - WAIVER
Active
Other names
Gibault Children's Services
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELE MADLEY MS LMHC (PRESIDENT/CEO)
(812) 298-3002
Entity
Organization
Contact information
Practice address
6401 S US HIGHWAY 41, TERRE HAUTE, IN 47802-4749
(812) 298-3002
(812) 298-3044
Mailing address
6401 S US HIGHWAY 41, TERRE HAUTE, IN 47802-4749
(812) 298-3002
(812) 298-3044
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
32301
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200897960 A
—
IN
Enumeration date
07/17/2008
Last updated
08/30/2012
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