Provider Demographics
NPI:1982860813
Name:TEENS IN ACTION, INC.
Entity Type:Organization
Organization Name:TEENS IN ACTION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BRIDGETTE
Authorized Official - Middle Name:L
Authorized Official - Last Name:SPANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-397-5117
Mailing Address - Street 1:1015 E 149TH ST
Mailing Address - Street 2:
Mailing Address - City:EAST CHICAGO
Mailing Address - State:IN
Mailing Address - Zip Code:46312-3771
Mailing Address - Country:US
Mailing Address - Phone:219-397-5117
Mailing Address - Fax:
Practice Address - Street 1:1015 E 149TH ST
Practice Address - Street 2:
Practice Address - City:EAST CHICAGO
Practice Address - State:IN
Practice Address - Zip Code:46312-3771
Practice Address - Country:US
Practice Address - Phone:219-397-5117
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-30
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health