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General NPI Number Information
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NPI Number | 1205452588
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Entity Type | Organization
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Legal Business Name | PATHFINDERS CHILD AND FAMILY SERVICES LLC
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Dates
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Enumeration Date | 06/22/2020
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Last Update Date | 10/12/2021
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Provider Practice Location Address
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Address Line | 10882 LANTERN VIEW DR APT 203
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City | FISHERS
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State | IN
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Zip | 46038-4212
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Country | US
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Telephone | 812-391-0358
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Fax |
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Provider Business Mailing Address
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Address Line | 10882 LANTERN VIEW DR APT 203
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City | FISHERS
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State | IN
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Zip | 46038-4212
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Country | US
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Telephone | 812-391-0358
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. MICHAEL CLARK
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Credential | MBA
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Telephone | 812-391-0358
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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