Provider Demographics
NPI:1033324801
Name:PEJUS, INC.
Entity Type:Organization
Organization Name:PEJUS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:M
Authorized Official - Last Name:BEAL
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:260-459-1551
Mailing Address - Street 1:1515 MAGNAVOX WAY
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46804-1533
Mailing Address - Country:US
Mailing Address - Phone:260-459-1551
Mailing Address - Fax:260-459-1451
Practice Address - Street 1:1515 MAGNAVOX WAY
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46804-1533
Practice Address - Country:US
Practice Address - Phone:260-459-1551
Practice Address - Fax:260-459-1451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities