Provider First Line Business Practice Location Address:
1758 W 100S
Provider Second Line Business Practice Location Address:
JAY COUNTY HOPSITAL BEHAVIORAL HEALTH
Provider Business Practice Location Address City Name:
PORTLAND
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47371
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
260-726-1865
Provider Business Practice Location Address Fax Number:
260-726-1901
Provider Enumeration Date:
03/23/2007