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Organization

GIBAULT, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JAMES M SINCLAIR MSSW, JD (PRESIDENT CEO)
(812) 298-3002
Entity
Organization

Contact information

Practice address
6301 S US HWY 41, TERRE HAUTE, IN 47802-0316
(812) 299-1156
Mailing address
6301 S US HWY 41, PO BOX 2316, TERRE HAUTE, IN 47802-0316
(812) 299-1156

Taxonomy

Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
32301
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200480150A
IN
Enumeration date
11/07/2006
Last updated
07/17/2008
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