Provider Demographics
NPI:1548228331
Name:LYNNE ECKERLE
Entity Type:Organization
Organization Name:LYNNE ECKERLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERIM AGENCY DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYNNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ECKERLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-314-2982
Mailing Address - Street 1:1531 13TH ST., STE G-900
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47201-1302
Mailing Address - Country:US
Mailing Address - Phone:812-314-2982
Mailing Address - Fax:812-373-3620
Practice Address - Street 1:1531 13TH ST., STE G-900
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-1302
Practice Address - Country:US
Practice Address - Phone:812-314-2982
Practice Address - Fax:812-373-3620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-02
Last Update Date:2010-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251G00000XAgenciesHospice Care, Community Based
No252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200343700 AMedicaid
IN100264620 AMedicaid