Organization
PARK CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STANTON RISSER (ACFO)
(260) 266-9380
Entity
Organization
Contact information
Practice address
909 E STATE BLVD, FORT WAYNE, IN 46805-3404
(260) 481-2700
(260) 481-2717
Mailing address
909 E STATE BLVD, FORT WAYNE, IN 46805-3404
(260) 481-2700
(260) 481-2717
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100463190A
—
IN
05
—
100463190B
—
IN
Enumeration date
12/06/2007
Last updated
10/31/2024
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