Provider Demographics
NPI:1710303904
Name:ZEILBECK GROUP INCORPORATED
Entity Type:Organization
Organization Name:ZEILBECK GROUP INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:ZEILBECK
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:219-575-1437
Mailing Address - Street 1:717 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:LA PORTE
Mailing Address - State:IN
Mailing Address - Zip Code:46350-3356
Mailing Address - Country:US
Mailing Address - Phone:219-575-1437
Mailing Address - Fax:
Practice Address - Street 1:717 MONROE ST
Practice Address - Street 2:
Practice Address - City:LA PORTE
Practice Address - State:IN
Practice Address - Zip Code:46350-3356
Practice Address - Country:US
Practice Address - Phone:219-575-1437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-12
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN101YM0800X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0OtherIN PROCESS