Provider Demographics
NPI:1053790311
Name:FAMILY HEARING CENTER, INC
Entity type:Organization
Organization Name:FAMILY HEARING CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:RENE
Authorized Official - Last Name:GINTER
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:574-533-2222
Mailing Address - Street 1:2134 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:IN
Mailing Address - Zip Code:46528-5004
Mailing Address - Country:US
Mailing Address - Phone:574-533-2222
Mailing Address - Fax:574-533-6868
Practice Address - Street 1:315 LEHMAN AVE
Practice Address - Street 2:SUITE C
Practice Address - City:TOPEKA
Practice Address - State:IN
Practice Address - Zip Code:46571-9476
Practice Address - Country:US
Practice Address - Phone:574-533-2222
Practice Address - Fax:574-533-6868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-20
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23002190A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200896580Medicaid
IN256980Medicare PIN