| Possibilities Northeast, Llc | |
|
808 Mill Lake Road Fort Wayne IN 46845-6400 | |
| (260) 338-1241 | |
| (260) 338-1231 |
| Full Name | Possibilities Northeast, Llc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 808 Mill Lake Road, Fort Wayne, Indiana |
| Authorized Official Name and Position | Nancy Moore (DIRECTOR) |
| Authorized Official Contact | 2603381241 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Possibilities Northeast, Llc 808 Mill Lake Road Fort Wayne IN 46845-6400 Ph: (260) 338-1241 | Possibilities Northeast, Llc 808 Mill Lake Road Fort Wayne IN 46845-6400 Ph: (260) 338-1241 |
| NPI Number | 1063616340 |
|---|---|
| Provider Enumeration Date | 06/12/2007 |
| Last Update Date | 09/05/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063616340 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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