THE ARC OF NORTHEAST INDIANA INC.
Intermediate Care Facility, Mentally Retarded
Fort Wayne, Indiana
Provider NPI: 1649333204
Organization Information:Organization Name: THE ARC OF NORTHEAST INDIANA INC.
Practice Location:
8626 STAND RIDGE RUN FORT WAYNE, IN 46825 US
Tel: 260-456-4534 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
8626 STAND RIDGE RUN FORT WAYNE, IN 46825 US
Tel: 260-456-4534 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 315P00000X | Nursing & Custodial Care Facilities Intermediate Care Facility, Mentally Retarded | IN | 2602B0010JN05 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
100244520 | IN | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin