Organization
CDC RESOURCES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL CRUZ (EXECUTIVE DIRECTOR)
(574) 583-8227
Entity
Organization
Contact information
Practice address
5053 NORWAY RD, MONTICELLO, IN 47960
(574) 583-8227
(574) 583-6454
Mailing address
5053 NORWAY RD, MONTICELLO, IN 47960
(574) 583-8227
(574) 583-6454
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
2647T0003DE06
IN
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
2647T0007DE06
IN
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
2647T0008DE07
IN
Other
Enumeration date
08/09/2006
Last updated
08/22/2020
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