| Pure Intention Services, Llc | |
|
6208 Constitution Dr Ste A1 Fort Wayne IN 46804-1585 | |
| (260) 833-7474 | |
| Not Available |
| Full Name | Pure Intention Services, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 6208 Constitution Dr Ste A1, Fort Wayne, Indiana |
| Authorized Official Name and Position | Erica Woodward (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2608337474 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pure Intention Services, Llc 6208 Constitution Dr Ste A1 Fort Wayne IN 46804-1585 Ph: (260) 833-7474 | Pure Intention Services, Llc 6208 Constitution Dr Ste A1 Fort Wayne IN 46804-1585 Ph: (260) 833-7474 |
| NPI Number | 1790506202 |
|---|---|
| Provider Enumeration Date | 10/18/2024 |
| Last Update Date | 10/18/2024 |
| Certification Date | 10/18/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790506202 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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