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Organization
WHEATFIELD RESIDENTIAL LLC
Active
Organization
WHEATFIELD RESIDENTIAL LLC
Active
Other names
Wheatfield Academy
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW STROUP (PROGRAM DIRECTOR)
(260) 600-9640
Entity
Organization
Contact information
Practice address
12501 IN-49, WHEATFIELD, IN 46392
(219) 235-9777
Mailing address
4150 ILLINOIS RD, FORT WAYNE, IN 46804-1208
(219) 235-9777
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/15/2023
Last updated
06/15/2023
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