Provider Demographics
NPI:1255946398
Name:MALTA CONSULTING AND FACILITATION SERVICES
Entity type:Organization
Organization Name:MALTA CONSULTING AND FACILITATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:L
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:317-833-6563
Mailing Address - Street 1:592 S PARK DR
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46140-8522
Mailing Address - Country:US
Mailing Address - Phone:317-833-6563
Mailing Address - Fax:
Practice Address - Street 1:592 S PARK DR
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:IN
Practice Address - Zip Code:46140-8522
Practice Address - Country:US
Practice Address - Phone:317-833-6563
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-15
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty