Provider Demographics
NPI:1740470442
Name:COUNT TO TEN, INC
Entity type:Organization
Organization Name:COUNT TO TEN, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:FRANKLYN
Authorized Official - Last Name:GARDNER
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:219-989-9759
Mailing Address - Street 1:5404 W 25TH AVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:GARY
Mailing Address - State:IN
Mailing Address - Zip Code:46406-3141
Mailing Address - Country:US
Mailing Address - Phone:219-989-9759
Mailing Address - Fax:219-989-9757
Practice Address - Street 1:5404 W 25TH AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:GARY
Practice Address - State:IN
Practice Address - Zip Code:46406-3141
Practice Address - Country:US
Practice Address - Phone:219-989-9759
Practice Address - Fax:219-989-9757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-28
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN6600003-01261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
INM400014630OtherMEDICARE IDENTIFICATION NUMBER
INM100014629OtherMEDICARE IDENTIFICATION NUMBER