Whalio Doctors

NPI 1184094013

Thomas Buckner

Practitioner Mental Illness Community Based Residential Treatment Facility Gary, IN

Practice location

Address
1100 W 6th Ave, Gary, IN 46402-1711
Phone
(219) 885-4264

Registered specialties (2)

Mental Illness Community Based Residential Treatment Facility Primary
Residential Treatment Facilities Taxonomy 320800000X
Mental Health Counselor
Behavioral Health & Social Service Providers Taxonomy 101YM0800X

Registry record

NPI
1184094013
Entity type
Individual
Sex (as registered)
Male
NPI issued
5 Oct 2015
Record last updated
5 Oct 2015

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.