Organization
WABASH CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER MORELAND (CHRO)
(765) 423-5531
Entity
Organization
Contact information
Practice address
411 PARK AVE, LAFAYETTE, IN 47904-3233
(765) 449-1139
Mailing address
PO BOX 6449, LAFAYETTE, IN 47903-6449
(765) 423-5531
(765) 423-4235
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100235320 A
—
IN
Enumeration date
04/13/2007
Last updated
03/20/2023
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