| NPI | 1851331615 |
|---|---|
| Doing Business As | SOUTHERNCARE FORT WAYNE |
| Entity Type | Organization |
| Authorized Contact | JESSICA KLEBERG VP Of Legal Affairs 704-664-2876 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251G00000X Hospice Care, Community Based (Licence: IN 14-002563-1) |
| Additional Taxonomies | 251G00000X Hospice Care, Community Based (Licence: IN 060025631) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2016-05-16 |