| Community Change Center: Weareone, Incorporated | |
|
4444 Connecticut St Gary IN 46409-2126 | |
| (219) 885-9560 | |
| Not Available |
| Full Name | Community Change Center: Weareone, Incorporated |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 4444 Connecticut St, Gary, Indiana |
| Authorized Official Name and Position | Samantha Burgett (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7654308952 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Change Center: Weareone, Incorporated 7112 Van Buren Ct Merrillville IN 46410-3859 Ph: (765) 430-8952 | Community Change Center: Weareone, Incorporated 4444 Connecticut St Gary IN 46409-2126 Ph: (219) 885-9560 |
| NPI Number | 1174373179 |
|---|---|
| Provider Enumeration Date | 03/25/2024 |
| Last Update Date | 03/25/2024 |
| Certification Date | 03/24/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174373179 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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