Individual provider · Type 1 NPI

Jacquis Sistrunk

Mental Illness Community Based Residential Treatment Facility · Gary, IN

NPI number 1447669098 Active

Practice location

1100 W 6th Ave
Gary, IN 46402-1711

Call (219) 885-4264 Map

Specialties and licenses

TaxonomyCodeLicense
Mental Illness Community Based Residential Treatment Facility Primary 320800000XNone listed

Mental Illness Community Based Residential Treatment Facility: A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

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About NPI 1447669098

Jacquis Sistrunk's National Provider Identifier is 1447669098, issued on Aug 7, 2014. The primary taxonomy on file is Mental Illness Community Based Residential Treatment Facility (320800000X), and the practice location is in Gary, IN. The record was last updated on Oct 11, 2026.