Northeastern Center,inc

NPI 1043414428 - Health Maintenance Organization - 302R00000X

NPI Details
NPI 1043414428
Enumeration Date 06/12/2007
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name SUSAN SUSAN
Position AREA DIRECTOR
Phone (126) 034-7440
Fax (126) 034-7312
Practice Location
1930 DOWLING ST
KENDALLVILLE IN, 46755-9436, US
Phone (126) 034-7440
Fax (126) 034-7312
Business Location
1930 DOWLING ST
KENDALLVILLE IN, 46755-9436, US
Phone (126) 034-7440
Fax (126) 034-7312
Toxanomy
Taxonomy Code 302R00000X
License State Indiana
License Number 101YM0800X
Remove 1043414428 NPI Number
 

According to our database, Northeastern Center,inc NPI is 1043414428, taxonomy code is 302R00000X and license number is 101YM0800X, license state is located at Indiana. Northeastern Center,inc physically located at 1930 Dowling St, Kendallville IN, 46755-9436. NPI Number 1033115704 has the healthcare provider type.

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1043414428 NPI number is provided on an as is basis without warranty of any kind. 1043414428 is maintained by the National Plan & Provider Enumeration System. The contents of Northeastern Center,inc are for informational purposes only.