| Organization Name: | INDIANA HEALTH CENTERS, INC. |
| NPI Number: | 1750595765 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TERRANCE J. DRAKE (CHIEF MEDICAL OFFICER) |
| Mailing Address: | Tipton County Wic Program 119 West Washington Street Tipton |
| State: | IN US |
| Postal Code: | 46072 |
| Phone Number: | 7656758494 |
| Fax Number: | |
| NPI Enumeration Date: | 05/09/2007 |
| NPI Last Update Date: | 12/02/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251K00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Public Health or Welfare |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |