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General NPI Number Information
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NPI Number | 1417961475
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Entity Type | Organization
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Legal Business Name | PRO RESOURCES INC.
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5933 E STATE BLVD
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City | FORT WAYNE
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State | IN
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Zip | 46815
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Country | US
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Telephone | 260-969-3488
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Fax | 260-424-2204
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Provider Business Mailing Address
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Address Line | 1728 SPY RUN
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City | FORT WAYNE
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State | IN
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Zip | 46805
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | WILLIAM BECKER
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Credential |
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Telephone | 260-969-3488
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | IN
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