Organization
CENTER FOR LIFESTYLE CHANGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CAROLYN S LOHSE LSCW (OWNER)
(219) 395-6637
Entity
Organization
Contact information
Practice address
684 VALLEY DR, VALPARAISO, IN 46383-8912
(219) 395-6637
(219) 465-0784
Mailing address
PO BOX 1921, VALPARAISO, IN 46384-1921
(219) 395-6637
(219) 465-0784
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34001814A
IN
Other
Enumeration date
02/04/2011
Last updated
02/04/2011
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