Provider Demographics
NPI:1295396810
Name:NEOSSIA INC
Entity Type:Organization
Organization Name:NEOSSIA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BROOKE
Authorized Official - Middle Name:
Authorized Official - Last Name:FARRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW, CEDS-S
Authorized Official - Phone:260-358-7180
Mailing Address - Street 1:412 S SCOTT RD
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46814
Mailing Address - Country:US
Mailing Address - Phone:260-358-7180
Mailing Address - Fax:260-755-5731
Practice Address - Street 1:412 S SCOTT RD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46814
Practice Address - Country:US
Practice Address - Phone:260-358-7180
Practice Address - Fax:260-755-5731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)