Organization
UHS THE 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 N. 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
103TC0700X
Clinical Psychologist
73540
IN
103TC2200X
Clinical Child & Adolescent Psychologist
73540
IN
103TF0000X
Family Psychologist
73540
IN
103TP2701X
Group Psychotherapy Psychologist
73540
IN
2084P0800X
Psychiatry Physician
73540
IN
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
5180909873540
IN
323P00000X
Psychiatric Residential Treatment Facility
50266819873831
IN
323P00000X
Psychiatric Residential Treatment Facility
73540
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200465920A
—
IN
Enumeration date
02/09/2006
Last updated
07/03/2012
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