| Organization Name: | ALZHEIMER'S SERVICES OF NORTHERN INDIANA, INC. |
| NPI Number: | 1023136678 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GEORGE WILLIAM JACK (EXECUTIVE DIRECTOR) |
| Mailing Address: | 922 E Colfax Ave South Bend |
| State: | IN US |
| Postal Code: | 466172806 |
| Phone Number: | 5742324121 |
| Fax Number: | |
| NPI Enumeration Date: | 03/26/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 385HR2065X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Respite Care Facility |
| Taxonomy Classification: | Respite Care |
| Taxonomy Specialization: | Respite Care, Physical Disabilities, Child |
| Taxonomy Definition: | A facility or distinct part of a facility that providers short term, residential care to children, diagnosed with complex or profound disabilities as respite for the regular caregivers. |