Organization
CATHOLIC CHARITIES, DIOCESE OF GARY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DUANE D DEDELOW (DIOCESAN DIRECTOR)
(219) 886-3549
Entity
Organization
Contact information
Practice address
2642 ELEANOR ST, PORTAGE, IN 46368-3634
(219) 762-1177
(219) 762-1827
Mailing address
940 BROADWAY, GARY, IN 46402-2906
(219) 886-3549
(219) 886-2428
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5603009850243
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200085310
—
IN
Enumeration date
03/05/2007
Last updated
10/30/2013
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