Organization
WILLOWGLEN ACADEMY - INDIANA
Active
Parent organization
PHOENIX CARE SYSTEMS, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
PHOENIX CARE SYSTEMS, INC.
Authorized official
MS. LORENE CAMERON (EXECUTIVE DIRECTOR)
(219) 886-1320
Entity
Organization
Contact information
Practice address
2301 JEFFERSON ST, GARY, IN 46407-3043
(219) 886-2660
(219) 886-1319
Mailing address
2301 JEFFERSON ST, GARY, IN 46407-3043
(219) 886-2660
(219) 886-1319
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/30/2011
Last updated
12/30/2011
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