| Latitudes, Inc | |
|
6910 N Main St Unit 13c Granger IN 46530-9680 | |
| (574) 524-6307 | |
| (574) 222-1507 |
| Full Name | Latitudes, Inc |
|---|---|
| Speciality | Counselor |
| Location | 6910 N Main St, Granger, Indiana |
| Authorized Official Name and Position | Sharon Donnelly Keller (PRESIDENT) |
| Authorized Official Contact | 5745246307 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Latitudes, Inc 6910 N Main St Unit 13c Granger IN 46530-9680 Ph: (574) 524-6307 | Latitudes, Inc 6910 N Main St Unit 13c Granger IN 46530-9680 Ph: (574) 524-6307 |
| NPI Number | 1588079057 |
|---|---|
| Provider Enumeration Date | 06/24/2014 |
| Last Update Date | 06/24/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588079057 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | 39002503A (Indiana) | Primary |
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