Provider Demographics
NPI:1891352035
Name:NJUNGEA SERVICES LLC
Entity Type:Organization
Organization Name:NJUNGEA SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:N
Authorized Official - Last Name:NJUNGE
Authorized Official - Suffix:
Authorized Official - Credentials:THERAPIST
Authorized Official - Phone:317-560-2657
Mailing Address - Street 1:PO BOX 934
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:IN
Mailing Address - Zip Code:46131-0934
Mailing Address - Country:US
Mailing Address - Phone:317-560-2657
Mailing Address - Fax:317-739-3883
Practice Address - Street 1:708 HANNAH PL
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:IN
Practice Address - Zip Code:46131-7493
Practice Address - Country:US
Practice Address - Phone:317-560-2657
Practice Address - Fax:317-739-3883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-23
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1124227830Medicaid