George Junior Republic in Indiana

NPI #1508140898 in Gas City, Indiana

Provider Information

NPI Number: 1508140898
Entity Type: Organization
Organization Name: George Junior Republic in Indiana
Primary Specialty: Counselor
Enumeration Date: Oct 5, 2011
Last Updated: Apr 10, 2019

Practice Location

Address: 3925 S. GARTHWAITE RD
City: Gas City
State: Indiana
ZIP Code: 46933
Phone: (812) 722-3137

Authorized Official

Name: ALISA R COX, LCSW
Title: CLINICAL SUPERVISOR
Phone: (812) 722-3137

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary
Social Worker	104100000X
Marriage & Family Therapist	106H00000X
Foster Care Agency	253J00000X

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