# NORTHEASTERN CENTER,INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043414428
- **Authorized official:** MRS. SUSAN KAMARA MA,CRC,LPC (AREA DIRECTOR)
- **Authorized official phone:** 12603474400

## Contact information

- **Practice address:** 1930 DOWLING ST, KENDALLVILLE, IN 46755-9436
- **Practice address phone:** (126) 034-7440
- **Practice address fax:** (126) 034-7312
- **Mailing address:** 1930 DOWLING ST, KENDALLVILLE, IN 46755-9436
- **Mailing address phone:** (126) 034-7440
- **Mailing address fax:** (126) 034-7312

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | 101YM0800X | IN | Yes |

## Other

- **Enumeration date:** 06/12/2007
- **Last updated:** 08/22/2020