Organization
ADEC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA M SHIVELY (CEO/PRESIDENT)
(574) 848-7451
Entity
Organization
Contact information
Practice address
3426 PORTSMOUTH CT APT A, MISHAWAKA, IN 46545-3432
(574) 848-7451
Mailing address
PO BOX 398, 19670 SR 120, BRISTOL, IN 46507-0398
(574) 848-7451
(574) 848-5917
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
2670B0032JN04
IN
Other
Enumeration date
12/17/2010
Last updated
12/17/2010
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