Pwa & Spencer Home Llc | |
27 Pequignot Dr Pierceton IN 46562-9081 | |
(260) 702-3752 | |
(866) 681-7794 |
Full Name | Pwa & Spencer Home Llc |
---|---|
Speciality | Counselor |
Location | 27 Pequignot Dr, Pierceton, Indiana |
Authorized Official Name and Position | Kolby Rutherford (VP OF FINANCE & CONTROLLER) |
Authorized Official Contact | 2607023640 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Pwa & Spencer Home Llc 4150 Illinois Rd Fort Wayne IN 46804-1208 Ph: (260) 702-3640 | Pwa & Spencer Home Llc 27 Pequignot Dr Pierceton IN 46562-9081 Ph: (260) 702-3752 |
NPI Number | 1558025734 |
---|---|
Provider Enumeration Date | 10/25/2021 |
Last Update Date | 07/19/2024 |
Certification Date | 07/19/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1558025734 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101Y00000X | Counselor | (* (Not Available)) | Primary |
Lifeline Youth & Family Services, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 27 Pequignot Drive, Pierceton, IN 46562 Phone: 260-745-3322 |