Provider Demographics
NPI:1760257091
Name:VENA TREATMENT CENTER
Entity Type:Organization
Organization Name:VENA TREATMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:VENA
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:219-241-4419
Mailing Address - Street 1:954 EASTPORT CENTRE DR
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-4457
Mailing Address - Country:US
Mailing Address - Phone:219-241-4419
Mailing Address - Fax:
Practice Address - Street 1:954 EASTPORT CENTRE DR
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-4457
Practice Address - Country:US
Practice Address - Phone:219-241-4419
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-16
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)