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Organization
FAMILY CARE CENTER
Active
Organization
FAMILY CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLY R HAWKS (OFFICE MANAGER)
(260) 471-1950
Entity
Organization
Contact information
Practice address
2821 HILLEGAS RD, FORT WAYNE, IN 46808-3859
(260) 471-1950
(260) 471-1950
Mailing address
2821 HILLEGAS RD, FORT WAYNE, IN 46808-3859
(260) 471-1950
(260) 471-1950
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
103G00000X
Clinical Neuropsychologist
—
—
103T00000X
Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200530260A
—
IN
Enumeration date
07/22/2006
Last updated
08/26/2008
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