| Purpose-driven Community Services, Llc | |
|
1510 W 47th Ave Gary IN 46408-4438 | |
| (219) 688-6487 | |
| Not Available |
| Full Name | Purpose-driven Community Services, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1510 W 47th Ave, Gary, Indiana |
| Authorized Official Name and Position | Zaceri Williams (OWNER/CEO) |
| Authorized Official Contact | 7733895378 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Purpose-driven Community Services, Llc 1510 W 47th Ave Gary IN 46408-4438 Ph: (219) 688-6487 | Purpose-driven Community Services, Llc 1510 W 47th Ave Gary IN 46408-4438 Ph: (219) 688-6487 |
| NPI Number | 1942993191 |
|---|---|
| Provider Enumeration Date | 06/01/2023 |
| Last Update Date | 06/01/2023 |
| Certification Date | 06/01/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942993191 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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