Provider Demographics
NPI:1497923593
Name:PORTER COUNTY COMMUNITY SERVICES, INC
Entity Type:Organization
Organization Name:PORTER COUNTY COMMUNITY SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:H
Authorized Official - Last Name:LINDNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-464-9736
Mailing Address - Street 1:1005 CAMPBELL ST
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46385-4262
Mailing Address - Country:US
Mailing Address - Phone:219-464-9736
Mailing Address - Fax:219-462-6993
Practice Address - Street 1:1005 CAMPBELL ST
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46385-4262
Practice Address - Country:US
Practice Address - Phone:219-464-9736
Practice Address - Fax:219-462-6993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-12
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)