Organization
PASSION DRIVEN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAQUANA CAUSEY (OWNER)
(260) 602-9610
Entity
Organization
Contact information
Practice address
671 CANDLELITE CT, FORT WAYNE, IN 46807-3603
(260) 602-9610
Mailing address
671 CANDLELITE CT, FORT WAYNE, IN 46807-3603
(260) 602-9610
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
251S00000X
Community/Behavioral Health Agency
—
—
385HR2055X
Child Mental Illness Respite Care
Primary
—
—
Other
Enumeration date
12/16/2022
Last updated
12/16/2022
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