1962460279 NPI number — AIDS MINISTRIES/AIDS ASSIST OF NORTH INDIANA

Table of content: MS. ANGELA MARIA AIELLO MFT (NPI 1295982460)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962460279 NPI number — AIDS MINISTRIES/AIDS ASSIST OF NORTH INDIANA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AIDS MINISTRIES/AIDS ASSIST OF NORTH INDIANA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1962460279
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 11582
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SOUTH BEND
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46634-0582
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
574-234-2870
Provider Business Mailing Address Fax Number:
574-232-2872

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
201 S WILLIAM ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOUTH BEND
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46601-2515
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
574-234-2870
Provider Business Practice Location Address Fax Number:
574-232-2872
Provider Enumeration Date:
05/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BEATTY
Authorized Official First Name:
TOM
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF CLIENT SERVICES
Authorized Official Telephone Number:
574-234-2870

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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