Organization
THERAKIDS POTENTIAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARIE JEAN HEDGES RPT (OWNER)
(219) 742-3466
Entity
Organization
Contact information
Practice address
130 N WEST ST, CROWN POINT, IN 46307-3916
(219) 742-3466
Mailing address
PO BOX 14125, MERRILLVILLE, IN 46410-4125
(219) 742-3466
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
Other
Enumeration date
03/29/2011
Last updated
03/29/2011
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