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Park Center Inc
Substance Use Disorder Rehabilitation Clinic/Center in Fort Wayne, Indiana
NPI 1306897004

Park Center Inc is a Substance Use Disorder Rehabilitation Clinic/Center based in Fort Wayne, IN and is specialized in Rehabilitation, Substance Use Disorder. Park Center Inc practices in Fort Wayne, IN. The NPI Number for Park Center Inc is 1306897004 and holds a License No. (Indiana).

The current practice location address for Park Center Inc is 909 E State Blvd, Fort Wayne, IN and can be reached out via phone at 260-481-2700 and via fax at 260-481-2717.

Location: 909 E State Blvd, Fort Wayne, IN, 46845
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1306897004
Provider Name
Park Center Inc
Credential
Provider Entity Type
Organization
Address
909 E State Blvd, Fort Wayne, IN, 46845
Phone Number
260-481-2700
Fax Number
260-481-2717
Provider Enumeration Date
05/15/2006
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
100463190 C 05 IN
100463190B 05 IN
300015906 01 IN ADDICTION SERVICES
100463190A 05 IN
300024898 01 IN ADDICTION SERVICES
institution
Provider Business Practice Location Address Details
Address
909 E State Blvd
City
Fort Wayne
State
Indiana
Zip
46805-3404
Phone Number
260-481-2700
Fax Number
260-481-2717
person
Provider Business Mailing Address Details
Address
909 E State Blvd
City
Fort Wayne
State
Indiana
Zip
46805-3404
Phone Number
260-481-2700
Fax Number
260-481-2717
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Psychologist
Speciality
Addiction (Substance Use Disorder)
Taxonomy
103TA0400X
License No.
()
Definition
A psychologist with a proficiency that involves the application of psychological treatment of addiction stemming from the use of alcohol and other psychoactive substances (e.g., nicotine, marijuana, cocaine, heroin) or behavioral addictions (e.g., gambling) with the aim of cessation or reduction of use and/or the amelioration of emotional, behavioral, interpersonal and other problems arising from the addictive behavior.
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Mental Health (Including Community Mental Health Center)
Taxonomy
261QM0801X
License No.
(Indiana)
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Primary Care
Taxonomy
261QP2300X
License No.
419-0-CMHC (Indiana)
Definition
Definition to come...
person
Provider's Taxonomy Details 4
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Rehabilitation, Substance Use Disorder
Taxonomy
261QR0405X
License No.
()
Definition
Definition to come...
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