Organization
AXIS FAMILY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE D CLINE (EXECUTIVE DIRECTOR)
(765) 438-6625
Entity
Organization
Contact information
Practice address
1912 JONES PL, KOKOMO, IN 46902-5084
(765) 438-6625
Mailing address
1912 JONES PL, KOKOMO, IN 46902-5084
(765) 438-6625
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669964110
—
IN
Enumeration date
06/14/2018
Last updated
06/14/2018
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