Organization
LAKEVIEW WESLEYAN CHURCH
Active
Parent organization
LAKEVIEW WESLEYAN CHURCH
Other names
Life Center Counseling Service
Organization subpart
Yes
Provider details
NPI number
Legal business name
LAKEVIEW WESLEYAN CHURCH
Authorized official
APRIL D LEACH (OFFICIAL DELEGATE)
(765) 674-2208
Entity
Organization
Contact information
Practice address
5230 S WESTERN AVE, MARION, IN 46953-5778
(765) 674-2208
(765) 674-3273
Mailing address
5230 S WESTERN AVE, MARION, IN 46953-5778
(765) 674-2208
(765) 674-3273
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000175674
BLUE CROSS BLUE SHIELD
IN
05
—
100124010A
—
IN
05
—
100124010B
—
IN
01
—
1044124
CIGNA
IN
01
—
249441000
MAGELLAN
IN
01
—
351044
VALUE OPTIONS
IN
01
—
467557
AETNA
IN
Enumeration date
09/15/2006
Last updated
07/21/2022
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