Organization
BROADWAY PHYSICAL THERAPY, INC.
Active
Other names
DBA ProCare Home Health Services
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VANESSA REDD (ADMINISTRATOR)
(219) 887-2273
Entity
Organization
Contact information
Practice address
4950 BROADWAY, SUITE C, GARY, IN 46408-4605
(219) 887-2273
(219) 884-2848
Mailing address
4950 BROADWAY, SUITE C, GARY, IN 46408-4605
(219) 887-2273
(219) 884-2848
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
003042
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000236008
ANTHEM BLUE CROSS BLUE SH
IN
Enumeration date
06/30/2005
Last updated
04/03/2008
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