THE OTIS R BOWEN CENTER FOR HUMAN SERVICES INC NPI 1386159176

NPI Information

THE OTIS R BOWEN CENTER FOR HUMAN SERVICES INC is a methadone clinic center in Fort Wayne, IN. The provider is an entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. THE OTIS R BOWEN CENTER FOR HUMAN SERVICES INC NPI is 1386159176. The provider is registered as an organization entity type.
The provider Is Doing Business As Bowen Recovery Center.

The provider's business location address is:

1415 DIRECTORS ROW
FORT WAYNE, IN
ZIP 46808-297
Phone: (800) 342-5653
Fax: (574) 269-4189

The provider's authorized official is Jay Baumgartner .
The authorized official title is Sr. Vp Of Finance and has the following contact phone number (574) 267-7169.

The CLIA number assigned to this NPI record is 15D2297088 - federally qualified health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/4/2017 and was last updated on 12/4/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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