Syde By Syde Changes Llc | |
490 W 23rd Ave Gary IN 46407-3017 | |
(219) 333-7619 | |
Not Available |
Full Name | Syde By Syde Changes Llc |
---|---|
Speciality | Community/behavioral Health |
Location | 490 W 23rd Ave, Gary, Indiana |
Authorized Official Name and Position | Acquinnetta Doughty (CEO) |
Authorized Official Contact | 2193337619 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Syde By Syde Changes Llc 490 W 23rd Ave Gary IN 46407-3017 Ph: (219) 333-7619 | Syde By Syde Changes Llc 490 W 23rd Ave Gary IN 46407-3017 Ph: (219) 333-7619 |
NPI Number | 1841957362 |
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Provider Enumeration Date | 11/18/2021 |
Last Update Date | 06/04/2024 |
Certification Date | 06/04/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1841957362 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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