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General NPI Number Information
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NPI Number | 1043434806
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Entity Type | Organization
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Legal Business Name | WABASH CENTER, INC.
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 03/20/2023
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Provider Practice Location Address
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Address Line | 2305 CENTRAL ST
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City | LAFAYETTE
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State | IN
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Zip | 47905-1676
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Country | US
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Telephone | 765-447-9578
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Fax |
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Provider Business Mailing Address
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Address Line | 2000 GREENBUSH ST
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City | LAFAYETTE
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State | IN
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Zip | 47904-2255
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Country | US
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Telephone | 765-423-5531
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Fax | 765-423-4235
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Authorized Official
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Title or Position | CHRO
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Name | JENNIFER MORELAND
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Credential |
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Telephone | 765-423-5531
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number |
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License Number State |
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