Organization
EVANSVILLE CHRISTIAN LIFE CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATIE MERRICK GRUNOW (EXECUTIVE DIRECTOR)
(812) 423-9222
Entity
Organization
Contact information
Practice address
265 BELLEMEADE AVE, EVANSVILLE, IN 47713-1775
(812) 426-6152
(812) 426-6160
Mailing address
509 S KENTUCKY AVE, EVANSVILLE, IN 47714-1091
(812) 423-9222
(812) 428-8441
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
0005058783
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100180700A
—
IN
Enumeration date
11/27/2006
Last updated
10/15/2025
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