| Captiol City Family Education Services | |
|
6049 Broadway Merrillville IN 46410-2619 | |
| (219) 427-0193 | |
| Not Available |
| Full Name | Captiol City Family Education Services |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 6049 Broadway, Merrillville, Indiana |
| Authorized Official Name and Position | Carolyn Ann Thorpe (CLINICAL MANAGER) |
| Authorized Official Contact | 2194270193 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Captiol City Family Education Services 6049 Broadway Merrillville IN 46410-2619 Ph: (219) 427-0193 | Captiol City Family Education Services 6049 Broadway Merrillville IN 46410-2619 Ph: (219) 427-0193 |
| NPI Number | 1104296011 |
|---|---|
| Provider Enumeration Date | 10/05/2015 |
| Last Update Date | 10/05/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104296011 | NPI | - | NPPES |
| 1942561162 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 34006764A (Indiana) | Primary |
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