NPIMap

Organization Active NPI

Northeastern Center,Inc

  • Health Maintenance Organization
  • Kendallville, IN
National Provider Identifier
1043414428
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
101YM0800X Issued in IN
Legal business name
NORTHEASTERN CENTER,INC
Practice address
1930 Dowling St
Kendallville, IN 46755-9436
Phone
(126) 034-7440
Fax
(126) 034-7312
NPI assigned
Jun 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Susan Kamara, MA,CRC,LPC
Title
Area Director
Phone
(260) 347-4400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X 101YM0800X IN Primary

Addresses

Primary practice location

1930 Dowling St
Kendallville, IN 46755-9436

Mailing address

1930 Dowling St
Kendallville, IN 46755-9436
Phone (126) 034-7440

National Provider Directory

National Provider Directory
Tax ID family
Northeastern Center10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043414428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 DOWLING ST",
            "city": "KENDALLVILLE",
            "state": "IN",
            "postal_code": "467559436",
            "telephone_number": "126-034-7440",
            "fax_number": "126-034-7312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 DOWLING ST",
            "city": "KENDALLVILLE",
            "state": "IN",
            "postal_code": "467559436",
            "telephone_number": "126-034-7440",
            "fax_number": "126-034-7312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEASTERN CENTER,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KAMARA",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "AREA DIRECTOR",
        "authorized_official_telephone_number": "12603474400",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA,CRC,LPC"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "IN",
            "license": "101YM0800X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kendallville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.