| Allendale Academy Llc | |
|
454 E Dupont Rd Fort Wayne IN 46825-2050 | |
| (239) 888-4910 | |
| Not Available |
| Full Name | Allendale Academy Llc |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 454 E Dupont Rd, Fort Wayne, Indiana |
| Authorized Official Name and Position | Adam Hochberg (OWNER) |
| Authorized Official Contact | 2398884910 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Allendale Academy Llc 5419 County Road 427 Auburn IN 46706-9504 Ph: () - | Allendale Academy Llc 454 E Dupont Rd Fort Wayne IN 46825-2050 Ph: (239) 888-4910 |
| NPI Number | 1356007934 |
|---|---|
| Provider Enumeration Date | 11/09/2021 |
| Last Update Date | 11/09/2021 |
| Certification Date | 11/09/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356007934 | NPI | - | NPPES |
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