Organization
CAPITOL CITY FAMILY EDUCATION SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH SMITH MSW (PROGRAM MANAGER/THERAPIST)
(312) 918-9802
Entity
Organization
Contact information
Practice address
6049 BROADWAY, MERRILLVILLE, IN 46410-2619
(219) 427-0193
Mailing address
6049 BROADWAY, MERRILLVILLE, IN 46410-2619
(219) 427-0193
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Enumeration date
10/17/2016
Last updated
06/20/2017
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