| Prairie View Therapeutic Group Homes, Inc. | |
|
703 W Jefferson St Plymouth IN 46563-1651 | |
| (574) 936-2241 | |
| Not Available |
| Full Name | Prairie View Therapeutic Group Homes, Inc. |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 703 W Jefferson St, Plymouth, Indiana |
| Authorized Official Name and Position | Ted Hayden (DIRECTOR/OWNER) |
| Authorized Official Contact | 5749362241 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prairie View Therapeutic Group Homes, Inc. 703 W Jefferson St Plymouth IN 46563-1651 Ph: (574) 936-2241 | Prairie View Therapeutic Group Homes, Inc. 703 W Jefferson St Plymouth IN 46563-1651 Ph: (574) 936-2241 |
| NPI Number | 1679882922 |
|---|---|
| Provider Enumeration Date | 10/05/2010 |
| Last Update Date | 10/05/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679882922 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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