Organization
REPAIRER OF THE BREACH MINISTRIES INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MILDRED EWING (FOUNDER/CEO/CAO/CFO)
(219) 334-6393
Entity
Organization
Contact information
Practice address
3220 W RIDGE RD, GARY, IN 46408-1834
(219) 334-6393
Mailing address
3220 W RIDGE RD, GARY, IN 46408-1834
(219) 334-6393
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/07/2024
Last updated
01/16/2025
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