OrganizationActive
Clinical Services, LLC
NPI 1770725244 · Primary Care Clinic/Center · Fort Wayne, IN
Provider details
- NPI number
- 1770725244
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Rosie Milner, President(260) 458-8414
- License
- 71000514A (IN)
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
2315 Broadway
Fort Wayne, IN 46807-1103
Phone: (260) 458-8414
Fax: (260) 458-8414
Approximate (ZIP-level) locationGet directions
Mailing address
2315 Broadway
Fort Wayne, IN 46807-1103
Registry dates
- Enumerated
- 2009-03-30
- Last updated
- 2009-03-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.