| Center For Lifestyle Change | |
|
684 Valley Dr Valparaiso IN 46383-8912 | |
| (219) 395-6637 | |
| (219) 465-0784 |
| Full Name | Center For Lifestyle Change |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 684 Valley Dr, Valparaiso, Indiana |
| Authorized Official Name and Position | Carolyn S Lohse (OWNER) |
| Authorized Official Contact | 2193956637 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Center For Lifestyle Change Po Box 1921 Valparaiso IN 46384-1921 Ph: (219) 395-6637 | Center For Lifestyle Change 684 Valley Dr Valparaiso IN 46383-8912 Ph: (219) 395-6637 |
| NPI Number | 1669778866 |
|---|---|
| Provider Enumeration Date | 02/04/2011 |
| Last Update Date | 02/04/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669778866 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 34001814A (Indiana) | Primary |
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