Organization
PARK CENTER, INC.
Active
Parent organization
PARK CENTER, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
PARK CENTER, INC.
Authorized official
STANTON RISSER (ACFO)
(260) 266-9380
Entity
Organization
Contact information
Practice address
809 HIGH ST, DECATUR, IN 46733-2324
(260) 724-9669
(260) 724-4872
Mailing address
909 E STATE BLVD, FORT WAYNE, IN 46805-3404
(260) 481-2700
(260) 481-2709
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201033910A
—
IN
Enumeration date
11/22/2011
Last updated
10/31/2024
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