Willowglen Academy - Indiana

NPI #1073788113 in Gary, Indiana

Provider Information

NPI Number: 1073788113
Entity Type: Organization
Organization Name: Willowglen Academy - Indiana
Subpart: Yes (part of a larger organization)
Parent Organization: PHONENIX CARE SYSTEM
Primary Specialty: Residential Treatment Facility, Emotionally Disturbed Children
Enumeration Date: Apr 29, 2008
Last Updated: Jun 17, 2008

Practice Location

Address: 308 E 21ST AVE
City: Gary
State: Indiana
ZIP Code: 46407-2618
Phone: (219) 886-1320

Authorized Official

Name: MR. DWAYNE W MUELLER, RN
Title: EXECUTIVE DIRECTOR
Phone: (219) 886-1320

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Residential Treatment Facility, Emotionally Disturbed Children	322D00000X	Primary

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