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Organization
CHARLIE BOB, LLC
Active
Organization
CHARLIE BOB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES PACKER (OWNER/CEO)
(574) 265-1568
Entity
Organization
Contact information
Practice address
5202 SAINT JOE RD, SUITE 118, FORT WAYNE, IN 46835-3380
(260) 918-9525
Mailing address
5202 SAINT JOE RD, SUITE 118, FORT WAYNE, IN 46835-3380
(260) 918-9525
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
NULL
Other
Enumeration date
07/10/2015
Last updated
07/10/2015
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