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
1012 W. INDIANA ST, KOUTS, IN 46347-9703
(219) 766-2999
(219) 766-2704
Mailing address
P.O. 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
5180909873540
IN
103T00000X
Psychologist
Primary
5180909873540
IN
103T00000X
Psychologist
73540
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200465920A
—
IN
Enumeration date
07/26/2010
Last updated
10/30/2012
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