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General NPI Number Information
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NPI Number | 1487048005
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Entity Type | Organization
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Legal Business Name | CAREER ACADEMY OF SOUTH BEND, INC.
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Dates
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Enumeration Date | 03/20/2015
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Last Update Date | 03/20/2015
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Provider Practice Location Address
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Address Line | 3801 CRESCENT CIR
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City | SOUTH BEND
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State | IN
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Zip | 46628-6136
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Country | US
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Telephone | 574-299-9800
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Fax | 574-288-6125
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Provider Business Mailing Address
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Address Line | 3801 CRESCENT CIR
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City | SOUTH BEND
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State | IN
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Zip | 46628-6136
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Country | US
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Telephone | 574-299-9800
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Fax | 574-288-6125
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Authorized Official
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Title or Position | ASSISTANT SECRETARY/ATTORNEY
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Name | MR. CHARLES M LOESER
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Credential |
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Telephone | 574-271-5145
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number | 7564
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License Number State | IN
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