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832 N Meridian St Indianapolis IN 46204-1108 | |
| (317) 686-5634 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 832 N Meridian St, Indianapolis, Indiana |
| Authorized Official Name and Position | Christopher Scott (PRESIDENT AND CEO) |
| Authorized Official Contact | 3178804440 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
720 Eskenazi Ave Fifth Third Bank Building/5th Floor Indianpolis IN 46202-5166 Ph: (317) 880-3999 | 832 N Meridian St Indianapolis IN 46204-1108 Ph: (317) 686-5634 |
| NPI Number | 1760922249 |
|---|---|
| Provider Enumeration Date | 03/02/2017 |
| Last Update Date | 09/05/2023 |
| Certification Date | 09/05/2023 |
| Medicare PECOS PAC ID | 6709795974 |
|---|---|
| Medicare Enrollment ID | O20240627000357 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760922249 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TA0400X | Psychologist - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 261QM2800X | Clinic/center - Methadone | (* (Not Available)) | Primary |
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