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Organization
AGING & IN-HOME SERVICES OF NORTHEAST INDIANA, INC.
Active
Organization
AGING & IN-HOME SERVICES OF NORTHEAST INDIANA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETH KRUDOP (CASE MANAGER SUPERVISOR)
(260) 745-1200
Entity
Organization
Contact information
Practice address
2927 LAKE AVE, FORT WAYNE, IN 46805-5415
(260) 745-1200
(260) 469-3079
Mailing address
2927 LAKE AVE, FORT WAYNE, IN 46805-5415
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200343870
—
IN
Enumeration date
04/25/2007
Last updated
07/11/2008
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