Healthcare Provider Details

I. General information

NPI: 1245361872
Provider Name (Legal Business Name): QUINCO CONSULTING CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

806 JACKSON ST
COLUMBUS IN
47201-6264
US

IV. Provider business mailing address

720 N MARR RD
COLUMBUS IN
47201-6660
US

V. Phone/Fax

Practice location:
  • Phone: 812-379-4033
  • Fax: 812-378-8367
Mailing address:
  • Phone: 812-314-3400
  • Fax: 812-378-8367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateIN

VIII. Authorized Official

Name: DR. ROBERT WILLIAMS
Title or Position: CEO
Credential: PHD, HSPP
Phone: 812-314-3400