15D2258923 CLIA NUMBER - GILEAD HOUSE, INC

Laboratory Demographics

CLIA Number: 15D2258923

Facility Name: GILEAD HOUSE, INC

Facility Address:
406 E SYCAMORE STREET
KOKOMO, IN
ZIP 46901
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Facility Phone Number: 765 865-9427

Facility Type: Other - RECOVERY RESIDENCE

Certificate Type: Waiver

NPI Number: 1194218024

Taxonomy: 261QM0850X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.

CLIA Record

Field Name	Field Value
CLIA Number	15D2258923
LAB Type	Other - RECOVERY RESIDENCE
Facility Name	GILEAD HOUSE, INC
Street	406 E SYCAMORE STREET
City	KOKOMO
State	IN
ZIP	46901
Phone	765 865-9427
CertificateType	4
CertificateEffectiveDate	4/28/2024
CertificateExpirationDate	4/27/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024