Organization
ALLEN COUNTY DRUG AND ALCOHOL CONSORTIUM, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINA L WISE LCSW (CLINICAL DIRECTOR)
(260) 424-3629
Entity
Organization
Contact information
Practice address
532 W JEFFERSON BLVD, FORT WAYNE, IN 46802-2906
(260) 422-8412
Mailing address
532 W JEFFERSON BLVD, FORT WAYNE, IN 46802-2906
(260) 422-8412
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
12/12/2022
Last updated
12/12/2022
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