Organization
UHS MIDWEST CENTER FOR YOUTH & FAMILIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL JOHN PERRY (CEO)
(219) 766-2999
Entity
Organization
Contact information
Practice address
2301 CUMBERLAND DR, VALPARAISO, IN 46383-2537
(219) 766-2999
(219) 766-2704
Mailing address
PO BOX 669, 1012 W. INDIANA ST, KOUTS, IN 46347-9703
(219) 766-2999
(219) 766-2704
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
50266819873831
—
103TC0700X
Clinical Psychologist
73831
IN
103TC2200X
Clinical Child & Adolescent Psychologist
73831
IN
103TF0000X
Family Psychologist
73831
IN
103TP2701X
Group Psychotherapy Psychologist
73831
IN
2084P0800X
Psychiatry Physician
73831
IN
323P00000X
Psychiatric Residential Treatment Facility
Primary
50266819873831
IN
323P00000X
Psychiatric Residential Treatment Facility
73831
IN
Other
Enumeration date
06/17/2008
Last updated
10/30/2012
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