Organization
NORTHEASTERN CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENEE RUNKLE (ADMINISTRATIVE SERVICES COORDINATOR)
(260) 347-2453
Entity
Organization
Contact information
Practice address
220 S MAIN ST, KENDALLVILLE, IN 46755-1718
(260) 347-2453
(260) 347-2456
Mailing address
PO BOX 817, KENDALLVILLE, IN 46755-0817
(260) 347-2453
(260) 347-2456
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
426-0-CMHC
IN
Other
Enumeration date
01/29/2007
Last updated
08/22/2020
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