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General NPI Number Information
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NPI Number | 1518247766
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Entity Type | Organization
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Legal Business Name | SOUTH CENTRAL COMMUNITY ACTION PROGRAM
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Dates
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Enumeration Date | 08/19/2011
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Last Update Date | 08/19/2011
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Provider Practice Location Address
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Address Line | 1502 W 15TH ST
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City | BLOOMINGTON
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State | IN
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Zip | 47404-3018
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Country | US
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Telephone | 812-334-8350
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Fax | 812-335-3637
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Provider Business Mailing Address
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Address Line | 1502 W 15TH ST
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City | BLOOMINGTON
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State | IN
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Zip | 47404-3018
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Country | US
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Telephone | 812-334-8350
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Fax | 812-335-3637
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Authorized Official
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Title or Position | HEAD START DIRECTOR
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Name | DR. SHIRLEY S STUMPNER
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Credential |
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Telephone | 812-334-8350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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