| Organization Name: | GERALD LEWIS INC. |
| NPI Number: | 1053650887 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GERALD C. LEWIS (OWNER) |
| Mailing Address: | 1150 Eastport Centre Dr Suite D Valparaiso |
| State: | IN US |
| Postal Code: | 463838427 |
| Phone Number: | 2192863907 |
| Fax Number: | 2192863911 |
| NPI Enumeration Date: | 02/14/2013 |
| NPI Last Update Date: | 02/14/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364SP0808X |
| License Number: | 70000167A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |