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General NPI Number Information
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NPI Number | 1720452014
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Entity Type | Organization
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Legal Business Name | LAGRANGE COUNTY DBA LAGRANGE COUNTY HEALTH DEPARTMENT
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Dates
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Enumeration Date | 11/24/2015
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Last Update Date | 11/24/2015
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Provider Practice Location Address
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Address Line | 304 N TOWNLINE RD
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City | LAGRANGE
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State | IN
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Zip | 46761-1326
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Country | US
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Telephone | 260-499-4182
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Fax | 260-499-4189
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Provider Business Mailing Address
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Address Line | 304 N TOWNLINE RD
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City | LAGRANGE
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State | IN
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Zip | 46761-1326
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Country | US
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Telephone | 260-499-4182
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Fax | 260-499-4189
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Authorized Official
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Title or Position | HEALTH DEPARTMENT ADMINISTRATOR
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Name | MR. ALFREDO GARCIA
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Credential | PHD
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Telephone | 260-499-4182
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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