Organization
LATITUDES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON DONNELLY KELLER (PRESIDENT)
(574) 524-6307
Entity
Organization
Contact information
Practice address
6910 N MAIN ST, UNIT 13C, GRANGER, IN 46530-9680
(574) 524-6307
(574) 222-1507
Mailing address
6910 N MAIN ST, UNIT 13C, GRANGER, IN 46530-9680
(574) 524-6307
(574) 222-1507
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
39002503A
IN
Other
Enumeration date
06/24/2014
Last updated
06/24/2014
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