| Nusource Educational Service | |
|
4270 Ohio St Gary IN 46409-2006 | |
| (219) 980-6217 | |
| (219) 985-8772 |
| Full Name | Nusource Educational Service |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 4270 Ohio St, Gary, Indiana |
| Authorized Official Name and Position | Katherlyn Thedford (CHIEF OF OPERATIONS) |
| Authorized Official Contact | 2199806217 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nusource Educational Service 4270 Ohio St Gary IN 46409-2006 Ph: (219) 980-6217 | Nusource Educational Service 4270 Ohio St Gary IN 46409-2006 Ph: (219) 980-6217 |
| NPI Number | 1124108733 |
|---|---|
| Provider Enumeration Date | 10/17/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124108733 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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