Healthcare Provider Details

I. General information

NPI: 1780059790
Provider Name (Legal Business Name): ADVANCED CARE CONNECTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2015
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 N. JOHNSON STREET
BLUFFTON IN
46714-1910
US

IV. Provider business mailing address

110 N. JOHNSON STREET
BLUFFTON IN
46714-1910
US

V. Phone/Fax

Practice location:
  • Phone: 260-739-5821
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: GREG C MANN
Title or Position: OWNER
Credential:
Phone: 260-750-3965