NPI 1275905861

De'Loria Green

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

Mental Illness Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320800000X

Other Community Based Residential Treatment Facility, Mental Illness providers in Indiana →

Registry record

NPI: 1275905861
Entity type: Individual
Sex (as registered): Female
NPI issued: 22 Oct 2015
Record last updated: 22 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.