Organization
PACE OF NORTHEAST INDIANA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AARON L SHAPIRO (CFO)
(260) 745-1200
Entity
Organization
Contact information
Practice address
2927 LAKE AVE, FORT WAYNE, IN 46805-5415
(260) 745-1200
Mailing address
8101 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4163
(260) 745-1200
(260) 745-5968
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
—
—
Other
Enumeration date
09/19/2019
Last updated
09/19/2019
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