Interdisciplinary Diagnostic & Evaluation Center, Inc.
LBN: Interdisciplinary Diagnostic & Evaluation Center, Inc.
Interdisciplinary Diagnostic & Evaluation Center, Inc. is an health care organization with primary practice located at 3030 Lake Ave Ste 7 Ft. Wayne, Fort Wayne IN 46805-5428. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities, which is considered as the primary health care specialty.
Interdisciplinary Diagnostic & Evaluation Center, Inc. can be contacted via phone (260) 422-2838, or through Donn, Patsy A. via phone (260) 422-2838.
Contact Information
Primary practice address
3030 Lake Ave Ste 7 Ft. Wayne
Fort Wayne IN 46805-5428
Phone: (260) 422-2838
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities | 103TM1800X | 20090014A | Indiana |
Profile Details
| NPI number | 1134395510 |
|---|---|
| LBN Legal business name | Interdisciplinary Diagnostic & Evaluation Center, Inc. |
| DBA Doing business as | |
| Authorized official | Donn, Patsy A. ED.D. |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | May 5th, 2008 |
| Last updated | May 5th, 2008 - about 16 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134395510 | NPPES |
| Indiana | MEDICAID | 100080770 A |
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