Provider Demographics
NPI:1083348247
Name:LEXINGTON HOUSE OF ELKHART, IN
Entity Type:Organization
Organization Name:LEXINGTON HOUSE OF ELKHART, IN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:
Authorized Official - Last Name:DISORI
Authorized Official - Suffix:
Authorized Official - Credentials:SOCIAL WORKER
Authorized Official - Phone:574-326-0846
Mailing Address - Street 1:2626 PRAIRIE ST
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46517-2127
Mailing Address - Country:US
Mailing Address - Phone:574-326-0846
Mailing Address - Fax:
Practice Address - Street 1:2626 PRAIRIE ST
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46517-2127
Practice Address - Country:US
Practice Address - Phone:574-326-0846
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-13
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health