Provider Demographics
NPI:1689958365
Name:CAMPAGNA ACADEMY INC.
Entity Type:Organization
Organization Name:CAMPAGNA ACADEMY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:STEVENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-322-8614
Mailing Address - Street 1:7403 CLINE AVE
Mailing Address - Street 2:
Mailing Address - City:SCHERERVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46375-2645
Mailing Address - Country:US
Mailing Address - Phone:219-322-8614
Mailing Address - Fax:219-322-8436
Practice Address - Street 1:7403 CLINE AVE
Practice Address - Street 2:
Practice Address - City:SCHERERVILLE
Practice Address - State:IN
Practice Address - Zip Code:46375-2645
Practice Address - Country:US
Practice Address - Phone:219-322-8614
Practice Address - Fax:219-322-8436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-29
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty