National Provider Identifier Database

CLUBHOUSE OF SAINT JOSEPH COUNTY
Voluntary or Charitable


Contact Information

CLUBHOUSE OF SAINT JOSEPH COUNTY
1216 WAYNE ST N
SOUTH BEND, IN46615-1036
Phone: 574-360-8409
Fax: 574-966-1443
Website:
Specialty Taxonomy Code
* Voluntary or Charitable 251V00000X
Community/Behavioral Health 251S00000X

* Indicates primary specialty

NPI Profile & details for CLUBHOUSE OF SAINT JOSEPH COUNTY

NPI Number 1649723628
Legal business name
LBN
CLUBHOUSE OF SAINT JOSEPH COUNTY
Authorized official MARK BUCHANAN - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 07/26/2016
Last updated 07/26/2016 - About 10 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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