Provider Demographics
NPI:1962460279
Name:AIDS MINISTRIES/AIDS ASSIST OF NORTH INDIANA
Entity Type:Organization
Organization Name:AIDS MINISTRIES/AIDS ASSIST OF NORTH INDIANA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLIENT SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:TOM
Authorized Official - Middle Name:
Authorized Official - Last Name:BEATTY
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:574-234-2870
Mailing Address - Street 1:PO BOX 11582
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46634-0582
Mailing Address - Country:US
Mailing Address - Phone:574-234-2870
Mailing Address - Fax:574-232-2872
Practice Address - Street 1:201 S WILLIAM ST
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46601-2515
Practice Address - Country:US
Practice Address - Phone:574-234-2870
Practice Address - Fax:574-232-2872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management