NPI 1649723628

Clubhouse of Saint Joseph County

Organisation Voluntary or Charitable Agency South Bend, IN

Practice location

Address: 1216 Wayne St N, South Bend, IN 46615-1036
Phone: (574) 360-8409
Fax: (574) 966-1443
Mailing address: 525 Ostemo Pl, South Bend, IN 46617-1023

Authorised official

Name: Mark Dale Buchanan
Title: Executive Director
Phone: (574) 360-8409

Registered specialties (2)

Voluntary or Charitable Agency Primary

Agencies Taxonomy 251V00000X

Other Voluntary or Charitable providers in Indiana →

Community/Behavioral Health Agency

Agencies Taxonomy 251S00000X

Other Community/Behavioral Health providers in Indiana →

Registry record

NPI: 1649723628
Entity type: Organization
NPI issued: 26 Jul 2016
Record last updated: 26 Jul 2016

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.