Organization
TIP TOE INN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WANDA HARGRAVE (CEO)
(773) 419-1526
Entity
Organization
Contact information
Practice address
839 BROADWAY # 104, GARY, IN 46402-2414
(773) 419-1526
(219) 882-0210
Mailing address
839 BROADWAY # 104, GARY, IN 46402-2414
(773) 419-1526
(219) 882-0210
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/19/2013
Last updated
04/19/2013
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