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General NPI Number Information
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NPI Number | 1780778266
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Entity Type | Organization
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Legal Business Name | TRADEWINDS SERVICES, INC.
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 04/21/2015
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Provider Practice Location Address
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Address Line | 3198 E 83RD PL
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City | MERRILLVILLE
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State | IN
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Zip | 46410-6418
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Country | US
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Telephone | 219-945-0100
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Fax | 219-940-3369
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Provider Business Mailing Address
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Address Line | 3198 E 83RD PL
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City | MERRILLVILLE
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State | IN
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Zip | 46410-6418
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Country | US
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Telephone | 219-945-0100
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Fax | 219-940-3369
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. JON GOLD
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Credential |
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Telephone | 219-945-0100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 31000137A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 22003978A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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