Willowglen Academy - Indiana | |
308 E 21st Ave Gary IN 46407-2618 | |
(219) 886-1320 | |
Not Available |
Full Name | Willowglen Academy - Indiana |
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Speciality | Clinic/center - Adolescent And Children Mental Health |
Location | 308 E 21st Ave, Gary, Indiana |
Authorized Official Name and Position | Dwayne Warren Mueller (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 2198861320 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Willowglen Academy - Indiana 308 E 21st Ave Gary IN 46407-2618 Ph: (219) 886-1320 | Willowglen Academy - Indiana 308 E 21st Ave Gary IN 46407-2618 Ph: (219) 886-1320 |
NPI Number | 1487858411 |
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Provider Enumeration Date | 06/13/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1487858411 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0855X | Clinic/center - Adolescent And Children Mental Health | 53769 (Indiana) | Primary |
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