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NPI Code Detail

MEDICARE: YWCA NORTHEAST INDIANA INC

MEDICARE: YWCA NORTHEAST INDIANA INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2103T00000XPsychologist
3177F00000XLodging Provider
4324500000XSubstance Abuse Rehabilitation Facility

General Provider Information

NPI Number : 1629533658
Entity Type Code : Organization
Provider Name (Legal Business Name) : YWCA NORTHEAST INDIANA INC
Provider Business Mailing Address
First Line : 1313 W WASHINGTON CENTER RD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46825-4142
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1313 W WASHINGTON CENTER RD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46825-4142
Country : US
Telephone Number : 260-424-4908
Fax Number :
Authorized Official
Title or Position : CHIEF FINANCIAL OFFICER
Name : MRS. MICHELLE BANKS
Credential :
Telephone Number : 260-424-4908
Provider Enumeration Date : 02/04/2019
Last Update Date : 02/25/2025

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Directions to “YWCA NORTHEAST INDIANA INC ” Practice Location

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