Organization
THE SALVATION ARMY, AN ILLINOIS CORPORATION
Active
Other names
The Harbor Light Center
Organization subpart
No
Provider details
NPI number
Authorized official
BRAMWELL HIGGINS (CORPORATE SECRETARY)
(847) 294-2000
Entity
Organization
Contact information
Practice address
2400 N TIBBS AVE, INDIANAPOLIS, IN 46222-2458
(317) 972-1450
(317) 972-1075
Mailing address
2400 N TIBBS AVE, INDIANAPOLIS, IN 46222-2458
(317) 972-1450
(317) 972-1075
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
324500000X
—
IN
Enumeration date
08/16/2018
Last updated
08/16/2018
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