Organization
PROVIDENCE HOUSE
Active
Parent organization
PROVIDENCE SELF SUFFICIENCY MINISTRIES, INC.
Other names
Guerin Woods
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVIDENCE SELF SUFFICIENCY MINISTRIES, INC.
Authorized official
ELIZABETH PORTER ENGLAND PSYD, HSPP (EXECUTIVE DIRECTOR)
(502) 224-0789
Entity
Organization
Contact information
Practice address
8037 UNRUH DR, GEORGETOWN, IN 47122-8759
(812) 951-1878
(812) 951-0398
Mailing address
8037 UNRUH DR, GEORGETOWN, IN 47122-8759
(812) 951-1878
(812) 951-0398
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200358070
—
IN
Enumeration date
01/11/2007
Last updated
08/22/2024
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