Doctor Name: | ELIZABETH MARIE HARRIS |
NPI Number: | 1326410838 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MHT |
License Number: | |
Business Practice Address: | 4747 W 24th Ave Gary, IN - 464062821 |
Business Phone Number: | 2192408615 |
Business Fax Number: | 2199771197 |
Mailing Address: | 4747 W 24th Ave, GARY |
State: | IN |
Postal Code: | 464062821 |
Phone Number: | 2192408615 |
Fax Number: | 2199771197 |
NPI Enumeration Date: | 10/23/2015 |
NPI Last Update Date: | 10/23/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320800000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Community Based Residential Treatment Facility, Mental Illness |
Taxonomy Specialization: | |
Taxonomy Definition: | A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |