| Four Rivers & Associates Llc | |
|
4656 W Jefferson Blvd Suite 285 Fort Wayne IN 46804-6857 | |
| (260) 422-9372 | |
| (260) 672-0859 |
| Full Name | Four Rivers & Associates Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 4656 W Jefferson Blvd, Fort Wayne, Indiana |
| Authorized Official Name and Position | Andra D Johnson (OWNER) |
| Authorized Official Contact | 2167981997 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Four Rivers & Associates Llc 11014 Constantia Cv Roanoke IN 46783-8910 Ph: (216) 798-1997 | Four Rivers & Associates Llc 4656 W Jefferson Blvd Suite 285 Fort Wayne IN 46804-6857 Ph: (260) 422-9372 |
| NPI Number | 1336468271 |
|---|---|
| Provider Enumeration Date | 05/18/2010 |
| Last Update Date | 10/17/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336468271 | NPI | - | NPPES |
| 39628200 (-31/078) | Medicaid | WI |
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