| Family Service Society Inc | |
|
101 S Washington St Suite 200 Marion IN 46952-3867 | |
| (765) 662-9971 | |
| (765) 651-6563 |
| Full Name | Family Service Society Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 101 S Washington St, Marion, Indiana |
| Authorized Official Name and Position | Lisa Dominisse (CEO) |
| Authorized Official Contact | 7656629971 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Service Society Inc 101 S Washington St Suite 200 Marion IN 46952-3867 Ph: (765) 662-9971 | Family Service Society Inc 101 S Washington St Suite 200 Marion IN 46952-3867 Ph: (765) 662-9971 |
| NPI Number | 1780734806 |
|---|---|
| Provider Enumeration Date | 01/11/2007 |
| Last Update Date | 07/28/2020 |
| Certification Date | 07/28/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780734806 | NPI | - | NPPES |
| 100124250 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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