Organization
PERSONAL WELLNESS MEDICAL ADDICTION SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA VANDERBERG (FNP-BC, PMHNP-C)
(219) 742-7328
Entity
Organization
Contact information
Practice address
7805 TAFT ST STE E, MERRILLVILLE, IN 46410-5237
(219) 742-7328
(219) 343-5454
Mailing address
7805 TAFT ST STE E, MERRILLVILLE, IN 46410-5237
(219) 742-7328
(219) 343-5454
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1093019994
NPI
IN
Enumeration date
07/15/2025
Last updated
07/15/2025
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