Organization
INDIANA FAT LOSS CAMPS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BERNADETTE MARIE LAWRENCE RN (OWNER)
(708) 525-0583
Entity
Organization
Contact information
Practice address
6417 COLUMBIA AVE, HAMMOND, IN 46320-2747
(708) 525-0583
(219) 937-7736
Mailing address
6417 COLUMBIA AVE, HAMMOND, IN 46320-2747
(708) 525-0583
(219) 937-7736
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
10/13/2021
Last updated
10/13/2021
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