| Extra Special Parents Of Indiana, Llc | |
|
402 W Main St Madison IN 47250-3717 | |
| (812) 274-0228 | |
| (812) 274-0466 |
| Full Name | Extra Special Parents Of Indiana, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 402 W Main St, Madison, Indiana |
| Authorized Official Name and Position | Deborah Ooley (VICE PRESIDENT) |
| Authorized Official Contact | 8122740228 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Extra Special Parents Of Indiana, Llc 402 W Main St Madison IN 47250-3717 Ph: (812) 274-0228 | Extra Special Parents Of Indiana, Llc 402 W Main St Madison IN 47250-3717 Ph: (812) 274-0228 |
| NPI Number | 1033505946 |
|---|---|
| Provider Enumeration Date | 04/08/2015 |
| Last Update Date | 04/08/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033505946 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 16890ASO (Indiana) | Primary |
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