Healthcare Provider Details

I. General information

NPI: 1639223175
Provider Name (Legal Business Name): THE ARC OF NORTHEAST INDIANA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4919 COLDWATER RD.
FORT WAYNE IN
46825-5532
US

IV. Provider business mailing address

4919 COLDWATER RD.
FORT WAYNE IN
46825-5532
US

V. Phone/Fax

Practice location:
  • Phone: 260-456-4534
  • Fax: 260-745-5200
Mailing address:
  • Phone: 260-456-4534
  • Fax: 260-745-5200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. DONNA KRISTEEN ELBRECHT
Title or Position: CEO/PRESIDENT
Credential:
Phone: 260-456-4534