Provider Demographics
NPI:1649496449
Name:AIDS MINISTRIES AIDS ASSIST
Entity type:Organization
Organization Name:AIDS MINISTRIES AIDS ASSIST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CARE COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-293-9743
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:574-293-9743
Mailing Address - Fax:574-294-2867
Practice Address - Street 1:616 S MAIN ST
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46516-3216
Practice Address - Country:US
Practice Address - Phone:574-293-9743
Practice Address - Fax:574-294-2867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN251B00000X251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management