| Launchpad Foundation, Inc. | |
|
2200 Lake Ave Ste 260 Fort Wayne IN 46805-5351 | |
| (260) 424-0411 | |
| (260) 424-3530 |
| Full Name | Launchpad Foundation, Inc. |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 2200 Lake Ave Ste 260, Fort Wayne, Indiana |
| Authorized Official Name and Position | John W Blanks (ADMINISTRATIVE DIRECTOR) |
| Authorized Official Contact | 2604240411 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Launchpad Foundation, Inc. 2200 Lake Ave Ste 260 Fort Wayne IN 46805-5351 Ph: (260) 424-0411 | Launchpad Foundation, Inc. 2200 Lake Ave Ste 260 Fort Wayne IN 46805-5351 Ph: (260) 424-0411 |
| NPI Number | 1245974344 |
|---|---|
| Provider Enumeration Date | 04/25/2022 |
| Last Update Date | 04/25/2022 |
| Certification Date | 04/25/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245974344 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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