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1548421100

NPI Code Detail

MEDICARE: UHS MIDWEST CENTER FOR YOUTH & FAMILIES

MEDICARE: UHS MIDWEST CENTER FOR YOUTH & FAMILIES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC2200X	Clinical Child & Adolescent Psychologist	73831	IN
2	103TF0000X	Family Psychologist	73831	IN
3	103TP2701X	Group Psychotherapy Psychologist	73831	IN
4	2084P0800X	Psychiatry Physician	73831	IN
5	103TC0700X	Clinical Psychologist	73831	IN
6	323P00000X	Psychiatric Residential Treatment Facility	73831	IN
7	101YM0800X	Mental Health Counselor	50266819873831
8	323P00000X	Psychiatric Residential Treatment Facility	50266819873831	IN

General Provider Information

NPI Number	:	1548421100
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UHS MIDWEST CENTER FOR YOUTH & FAMILIES

Provider Business Mailing Address
First Line	:	PO BOX 669
Second Line	:	1012 W. INDIANA ST
City	:	KOUTS
State	:	IN
Zip	:	46347-9703
Country	:	US
Telephone Number	:	219-766-2999
Fax Number	:	219-766-2704

Provider Business Practice Location Address
First Line	:	2301 CUMBERLAND DR
Second Line	:
City	:	VALPARAISO
State	:	IN
Zip	:	46383-2537
Country	:	US
Telephone Number	:	219-766-2999
Fax Number	:	219-766-2704

Authorized Official
Title or Position	:	CEO
Name	:	MR. MICHAEL JOHN PERRY
Credential	:
Telephone Number	:	219-766-2999

Provider Enumeration Date	:	06/17/2008
Last Update Date	:	10/30/2012

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Directions to “UHS MIDWEST CENTER FOR YOUTH & FAMILIES ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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