Provider Demographics
NPI:1194990531
Name:CARDINAL CENTER, INC.--FIRST STEPS
Entity type:Organization
Organization Name:CARDINAL CENTER, INC.--FIRST STEPS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:N.
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-267-3823
Mailing Address - Street 1:504 N BAY DR
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:IN
Mailing Address - Zip Code:46580-4627
Mailing Address - Country:US
Mailing Address - Phone:574-267-3823
Mailing Address - Fax:574-267-6200
Practice Address - Street 1:504 N BAY DR
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:IN
Practice Address - Zip Code:46580-4627
Practice Address - Country:US
Practice Address - Phone:574-267-3823
Practice Address - Fax:574-267-6200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200717920Medicaid