Provider Demographics
NPI:1588907133
Name:CHRISTIAN COUNSELING AND ADDICTION SERVICES, INC.
Entity type:Organization
Organization Name:CHRISTIAN COUNSELING AND ADDICTION SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:R
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:LCAC
Authorized Official - Phone:765-533-3573
Mailing Address - Street 1:1398 W COUNTY ROAD 300 N
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:IN
Mailing Address - Zip Code:47362-9263
Mailing Address - Country:US
Mailing Address - Phone:765-533-3573
Mailing Address - Fax:765-533-3573
Practice Address - Street 1:4894 W STATE ROAD 38
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:IN
Practice Address - Zip Code:47362-8924
Practice Address - Country:US
Practice Address - Phone:765-533-3573
Practice Address - Fax:765-533-3573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-02
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN87000151A251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health