Organization
P L FORD HOMES/INDIANA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA L FORD (SOLE PROPRIETOR)
(219) 427-0407
Entity
Organization
Contact information
Practice address
519 E 60TH AVE, MERRILLVILLE, IN 46410-3068
(219) 427-0704
Mailing address
519 E 60TH AVE, MERRILLVILLE, IN 46410-3068
(219) 427-0407
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
200976520 A
IN
Other
Enumeration date
05/22/2010
Last updated
05/22/2010
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