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General NPI Number Information
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NPI Number | 1154882876
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Entity Type | Organization
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Legal Business Name | FAMILY COMMUNITY CONNECTIONS, INC
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Dates
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Enumeration Date | 03/26/2019
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 3639 N RACEWAY RD STE 400
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City | INDIANAPOLIS
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State | IN
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Zip | 46234-1678
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Country | US
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Telephone | 317-222-4236
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Fax | 317-981-5610
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Provider Business Mailing Address
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Address Line | 3639 N RACEWAY RD STE 400
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City | INDIANAPOLIS
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State | IN
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Zip | 46234-1678
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Country | US
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Telephone | 317-222-4236
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | VERONIKA GRIMES
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Credential | MS
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Telephone | 317-222-4236
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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