Provider Demographics
NPI:1063645752
Name:HAYES FAMILY WELLNESS CENTER PC
Entity Type:Organization
Organization Name:HAYES FAMILY WELLNESS CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SCHOEFFEL-HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:219-661-8680
Mailing Address - Street 1:11 E JOLIET ST
Mailing Address - Street 2:
Mailing Address - City:SCHERERVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46375-2010
Mailing Address - Country:US
Mailing Address - Phone:219-661-8680
Mailing Address - Fax:
Practice Address - Street 1:11 E JOLIET ST
Practice Address - Street 2:
Practice Address - City:SCHERERVILLE
Practice Address - State:IN
Practice Address - Zip Code:46375-2010
Practice Address - Country:US
Practice Address - Phone:219-661-8680
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-27
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002096A111N00000X
IN08002177A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty