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Thomas Buckner
Mental Illness Community Based Residential Treatment Facility in Gary, Indiana
NPI 1184094013

Thomas Buckner is a Mental Illness Community Based Residential Treatment Facility based in Gary, IN. Thomas Buckner practices in Gary, IN. The NPI Number for Thomas Buckner is 1184094013 and holds a License No. (Indiana).

The current practice location address for Thomas Buckner is 1100 W 6Th Ave, Gary, IN and can be reached out via phone at 219-885-4264.

Location: 1100 W 6Th Ave, Gary, IN, 46402-1711
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1184094013
Provider Name
Thomas Buckner
Credential
Provider Entity Type
Individual
Gender
Male
Address
1100 W 6Th Ave, Gary, IN, 46402-1711
Phone Number
219-885-4264
Fax Number
Provider Enumeration Date
10/05/2015
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1100 W 6Th Ave
City
Gary
State
Indiana
Zip
46402-1711
Phone Number
219-885-4264
Fax Number
person
Provider Business Mailing Address Details
Address
1100 W 6Th Ave
City
Gary
State
Indiana
Zip
46402-1711
Phone Number
219-885-4264
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Mental Illness
Speciality
-
Taxonomy
320800000X
License No.
()
Definition
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
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