MEDICARE: CHILD & FAMILY PARTNERS 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
1	251S00000X	Community/Behavioral Health Agency		IN

General Provider Information

NPI Number	:	1881857563
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHILD & FAMILY PARTNERS INC

Provider Business Mailing Address
First Line	:	115 FARABEE DR N STE C
Second Line	:	PO BOX 5173
City	:	LAFAYETTE
State	:	IN
Zip	:	47903-5173
Country	:	US
Telephone Number	:	765-427-6756
Fax Number	:	765-423-5600

Provider Business Practice Location Address
First Line	:	115 FARABEE DR N
Second Line	:	STE C
City	:	LAFAYETTE
State	:	IN
Zip	:	47903-5173
Country	:	US
Telephone Number	:	765-427-6756
Fax Number	:	765-423-5600

Authorized Official
Title or Position	:	PRESIDENT CEO
Name	:	MS. VIVIAN LEUCK
Credential	:	MS
Telephone Number	:	765-427-6756

Provider Enumeration Date	:	07/03/2008
Last Update Date	:	07/03/2008

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Directions to “CHILD & FAMILY PARTNERS INC ” Practice Location

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