Healthcare Provider Details

I. General information

NPI: 1811234099
Provider Name (Legal Business Name): ENCOURAGEMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2013
Last Update Date: 01/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1017 BONTRAGER AVE
ELKHART IN
46517-2811
US

IV. Provider business mailing address

PO BOX 1894
ELKHART IN
46515-1894
US

V. Phone/Fax

Practice location:
  • Phone: 574-226-5213
  • Fax:
Mailing address:
  • Phone: 574-226-5213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TEANDRA JELESE CONNER
Title or Position: OWNER
Credential:
Phone: 574-226-5213