Full Potential. Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

FULL POTENTIAL. INC

Practice address

700 W Toledo St
P.O 187
Fremont, IN 46737-7606

Phone

(260) 499-0359

NPI assigned

Dec 21, 2016

Last updated

Dec 21, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Cynthia Sue Church

Title

President

Phone

(260) 499-0359

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1482278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482278400000",
    "number": "1346785722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 W TOLEDO ST",
            "address_2": "P.O 187",
            "city": "FREMONT",
            "state": "IN",
            "postal_code": "467377606",
            "telephone_number": "260-499-0359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W TOLEDO ST",
            "address_2": "P.O 187",
            "city": "FREMONT",
            "state": "IN",
            "postal_code": "467377606",
            "telephone_number": "260-499-0359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL POTENTIAL. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-21",
        "last_updated": "2016-12-21",
        "status": "A",
        "authorized_official_last_name": "CHURCH",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "260-499-0359",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201404030-A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Providers in Fremont, IN by specialty
• Community/Behavioral Health Agency in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2016; 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.