Organization
BOSLEY ENTERPRISES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAPHAEL BOSLEY LMHC (OWNER)
(260) 440-0770
Entity
Organization
Contact information
Practice address
405 AIRPORT NORTH OFFICE PARK, FORT WAYNE, IN 46825-6704
(260) 440-0770
Mailing address
1109 WOODLAND XING, FORT WAYNE, IN 46825-7239
(260) 440-0770
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/20/2024
Last updated
08/20/2024
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