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General NPI Number Information
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NPI Number | 1013232719
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Entity Type | Organization
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Legal Business Name | CAMPAGNA ACADEMY
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Dates
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Enumeration Date | 04/06/2010
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Last Update Date | 04/06/2010
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Provider Practice Location Address
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Address Line | 7403 CLINE AVE
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City | SCHERERVILLE
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State | IN
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Zip | 46375-2645
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Country | US
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Telephone | 219-322-8614
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Fax | 219-322-8636
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Provider Business Mailing Address
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Address Line | 7403 CLINE AVE
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City | SCHERERVILLE
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State | IN
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Zip | 46375-2645
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Country | US
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Telephone | 219-322-8614
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Fax | 219-322-8636
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Authorized Official
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Title or Position | DIRECTOR OF ADMISISONS
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Name | MS. KAFREN ELISE WYATT
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Credential | MHS, CADACII
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Telephone | 219-322-8614
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number |
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License Number State | IN
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