Provider Demographics
NPI:1295032647
Name:COMMUNITY AND FAMILY SERVICES, INC.
Entity Type:Organization
Organization Name:COMMUNITY AND FAMILY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:VALIND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:260-726-9318
Mailing Address - Street 1:PO BOX 1087
Mailing Address - Street 2:521 SOUTH WAYNE STREET
Mailing Address - City:PORTLAND
Mailing Address - State:IN
Mailing Address - Zip Code:47371-3187
Mailing Address - Country:US
Mailing Address - Phone:260-726-9318
Mailing Address - Fax:260-726-9174
Practice Address - Street 1:521 S WAYNE ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:IN
Practice Address - Zip Code:47371-2519
Practice Address - Country:US
Practice Address - Phone:260-726-9318
Practice Address - Fax:260-726-9174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-22
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100146820Medicaid