Willowglen Academy - Indiana

NPI #1417227984 in Gary, Indiana

Provider Information

NPI Number: 1417227984
Entity Type: Organization
Organization Name: Willowglen Academy - Indiana
Subpart: Yes (part of a larger organization)
Parent Organization: PHOENIX CARE SYSTEMS, INC.
Primary Specialty: Residential Treatment Facility, Emotionally Disturbed Children
Enumeration Date: Dec 30, 2011
Last Updated: Dec 30, 2011

Practice Location

Address: 2301 JEFFERSON ST
City: Gary
State: Indiana
ZIP Code: 46407-3043
Phone: (219) 886-2660

Authorized Official

Name: MS. LORENE CAMERON
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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