| Instilling Hope Addiction Therapy, Llc | |
|
1690 Broadway Bld 19 Suite 10 Fort Wayne IN 46802-0010 | |
| (260) 409-8432 | |
| Not Available |
| Full Name | Instilling Hope Addiction Therapy, Llc |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 1690 Broadway Bld 19 Suite 10, Fort Wayne, Indiana |
| Authorized Official Name and Position | Terrell Jermaine Brown (OWNER/ CLINICAL ADDICTION THERAPIST) |
| Authorized Official Contact | 2602349009 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Instilling Hope Addiction Therapy, Llc 1690 Broadway Bld 19 Suite 10 Fort Wayne IN 46802-0010 Ph: (260) 409-8432 | Instilling Hope Addiction Therapy, Llc 1690 Broadway Bld 19 Suite 10 Fort Wayne IN 46802-0010 Ph: (260) 409-8432 |
| NPI Number | 1861210247 |
|---|---|
| Provider Enumeration Date | 10/02/2024 |
| Last Update Date | 10/02/2024 |
| Certification Date | 10/02/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861210247 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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