Provider Demographics
NPI:1184950974
Name:MISSING PIECES FAMILY SERVICES LLC LLC
Entity type:Organization
Organization Name:MISSING PIECES FAMILY SERVICES LLC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEANA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SEWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-271-8088
Mailing Address - Street 1:601 HILLSDALE DR
Mailing Address - Street 2:
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46901-3604
Mailing Address - Country:US
Mailing Address - Phone:765-271-8088
Mailing Address - Fax:765-452-5207
Practice Address - Street 1:8315 E COUNTY ROAD 700 N
Practice Address - Street 2:
Practice Address - City:FOREST
Practice Address - State:IN
Practice Address - Zip Code:46039-9617
Practice Address - Country:US
Practice Address - Phone:765-271-8088
Practice Address - Fax:765-452-5207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-29
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency