Organization
PURE INTENTION SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERICA WOODWARD (EXECUTIVE DIRECTOR)
(260) 833-7474
Entity
Organization
Contact information
Practice address
6208 CONSTITUTION DR STE A1, FORT WAYNE, IN 46804-1585
(260) 833-7474
Mailing address
6208 CONSTITUTION DR STE A1, FORT WAYNE, IN 46804-1585
(260) 833-7474
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
10/18/2024
Last updated
10/18/2024
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