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General NPI Number Information
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NPI Number | 1134760275
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Entity Type | Organization
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Legal Business Name | COMPASSIONATE LIVING NOW, INC.
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Dates
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Enumeration Date | 09/30/2019
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Last Update Date | 09/30/2019
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Provider Practice Location Address
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Address Line | 3100 E JOHN HINKLE PL STE 104
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City | BLOOMINGTON
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State | IN
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Zip | 47408-2611
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Country | US
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Telephone | 513-722-5698
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Fax |
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Provider Business Mailing Address
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Address Line | 2925 S OLCOTT BLVD
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City | BLOOMINGTON
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State | IN
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Zip | 47401-2403
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Country | US
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Telephone | 513-722-5698
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | STACEY KIM
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Credential | LCSW
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Telephone | 513-722-5698
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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