| Organization Name: | LATITUDES, INC |
| NPI Number: | 1588079057 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SHARON DONNELLY KELLER (PRESIDENT) |
| Mailing Address: | 6910 N Main St Unit 13c Granger |
| State: | IN US |
| Postal Code: | 465309680 |
| Phone Number: | 5745246307 |
| Fax Number: | 5742221507 |
| NPI Enumeration Date: | 06/24/2014 |
| NPI Last Update Date: | 06/24/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | 39002503A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |