NPI 1073788113

Willowglen Academy - Indiana

Organisation Emotionally Disturbed Childrens' Residential Treatment Facility Gary, IN

Practice location

Address: 308 E 21st Ave, Gary, IN 46407-2618
Phone: (219) 886-1320

Authorised official

Name: Dwayne W Mueller
Title: Executive Director
Phone: (219) 886-1320

Registered specialties

Emotionally Disturbed Childrens' Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 322D00000X Licence 33456 (IN)

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Registry record

NPI: 1073788113
Entity type: Organization
NPI issued: 29 Apr 2008
Record last updated: 17 Jun 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.