Organization
NORTHWEST INDIANA CENTER FOR FAMILY AND COMMUNITY SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL SOUTHERLAND (OWNER)
(219) 852-4095
Entity
Organization
Contact information
Practice address
6947 HOHMAN AVE, HAMMOND, IN 46324-1438
(219) 852-4095
(219) 932-0433
Mailing address
6947 HOHMAN AVE, HAMMOND, IN 46324-1438
(219) 852-4095
(219) 932-0433
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100124511
INDIANA STATE DEPARTMENT OF HEALTH
IN
Enumeration date
02/11/2011
Last updated
02/11/2011
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