Provider Demographics
NPI:1598887374
Name:GARY NEIGHBORHOOD SERVICES
Entity Type:Organization
Organization Name:GARY NEIGHBORHOOD SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERIM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:OSBORN
Authorized Official - Suffix:
Authorized Official - Credentials:DIRECTOR
Authorized Official - Phone:219-883-0431
Mailing Address - Street 1:300 W 21ST AVE
Mailing Address - Street 2:
Mailing Address - City:GARY
Mailing Address - State:IN
Mailing Address - Zip Code:46407-2511
Mailing Address - Country:US
Mailing Address - Phone:219-883-0431
Mailing Address - Fax:219-883-0919
Practice Address - Street 1:300 W 21ST AVE
Practice Address - Street 2:
Practice Address - City:GARY
Practice Address - State:IN
Practice Address - Zip Code:46407-2511
Practice Address - Country:US
Practice Address - Phone:219-883-0431
Practice Address - Fax:219-883-0919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health