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General NPI Number Information
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NPI Number | 1700177003
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Entity Type | Organization
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Legal Business Name | PARENTING PLUS, INX
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Dates
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Enumeration Date | 04/21/2011
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Last Update Date | 04/21/2011
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Provider Practice Location Address
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Address Line | 901 S ROGERS ST SUITE #103
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City | BLOOMINGTON
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State | IN
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Zip | 47403-4756
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Country | US
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Telephone | 812-333-4379
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Fax |
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Provider Business Mailing Address
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Address Line | 901 S ROGERS ST SUITE #103
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City | BLOOMINGTON
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State | IN
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Zip | 47403-4756
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Country | US
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Telephone | 812-333-4379
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. TERRY R. EADS
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Credential | LCSW, ACSW
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Telephone | 812-333-4379
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 34005321A
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License Number State | IN
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