Provider Demographics
NPI:1417475302
Name:JOHN DAVID INC
Entity Type:Organization
Organization Name:JOHN DAVID INC
Other - Org Name:MICHIANA HEALTH INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:HRAB
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:574-367-8580
Mailing Address - Street 1:51596 STATE ROAD 933
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46637-1704
Mailing Address - Country:US
Mailing Address - Phone:574-367-8580
Mailing Address - Fax:630-206-2439
Practice Address - Street 1:51596 STATE ROAD 933
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46637-1704
Practice Address - Country:US
Practice Address - Phone:574-367-8580
Practice Address - Fax:630-206-2439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-31
Last Update Date:2017-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management