| Centrality Behavior Support Training Llc | |
|
3725 E Southport Rd Suite F Indianapolis IN 46227-7829 | |
| (317) 796-6668 | |
| Not Available |
| Full Name | Centrality Behavior Support Training Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 3725 E Southport Rd, Indianapolis, Indiana |
| Authorized Official Name and Position | Meagan Dant (CLINICAL DIRECTOR) |
| Authorized Official Contact | 3175121878 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Centrality Behavior Support Training Llc 3725 E Southport Rd Suite F Indianapolis IN 46227-7829 Ph: (317) 677-6198 | Centrality Behavior Support Training Llc 3725 E Southport Rd Suite F Indianapolis IN 46227-7829 Ph: (317) 796-6668 |
| NPI Number | 1912329020 |
|---|---|
| Provider Enumeration Date | 01/08/2014 |
| Last Update Date | 02/05/2014 |
| Medicare PECOS PAC ID | 6406194992 |
|---|---|
| Medicare Enrollment ID | O20190207001661 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912329020 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| Provider Name | Elizabeth M Nallenweg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841675550 PECOS PAC ID: 1759621360 Enrollment ID: I20190319000193 |
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