| New Harvest Therapy Services, Inc. | |
|
8124 Calumet Ave Ste B Munster IN 46321 | |
| (317) 840-8963 | |
| Not Available |
| Full Name | New Harvest Therapy Services, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 8124 Calumet Ave Ste B, Munster, Indiana |
| Authorized Official Name and Position | Jean M Nanos (DIRECTOR/OWNER) |
| Authorized Official Contact | 2198528558 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New Harvest Therapy Services, Inc. Po Box 3294 Munster IN 46321-0294 Ph: (219) 852-8558 | New Harvest Therapy Services, Inc. 8124 Calumet Ave Ste B Munster IN 46321 Ph: (317) 840-8963 |
| NPI Number | 1407341787 |
|---|---|
| Provider Enumeration Date | 06/28/2018 |
| Last Update Date | 12/04/2018 |
| Medicare PECOS PAC ID | 7810232006 |
|---|---|
| Medicare Enrollment ID | O20181204001362 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407341787 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 20043103A (Indiana) | Primary |
| Provider Name | Lisette Haro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205968385 PECOS PAC ID: 2668656562 Enrollment ID: I20110418000181 |
| Provider Name | Irene Ortiz Verduzco |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275997504 PECOS PAC ID: 6507155819 Enrollment ID: I20160510000581 |
| Provider Name | Jean M Nanos |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003318122 PECOS PAC ID: 2264786359 Enrollment ID: I20181217000643 |
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