| Ics | |
|
921 E 86th St Ste 206 Indianapolis IN 46240-1841 | |
| (317) 730-3498 | |
| (317) 667-1881 |
| Full Name | Ics |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 921 E 86th St Ste 206, Indianapolis, Indiana |
| Authorized Official Name and Position | Stephen R Hudson (OWNER) |
| Authorized Official Contact | 3177303498 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ics 5342 Pelham Way Indianapolis IN 46216-2214 Ph: (317) 730-3498 | Ics 921 E 86th St Ste 206 Indianapolis IN 46240-1841 Ph: (317) 730-3498 |
| NPI Number | 1306306147 |
|---|---|
| Provider Enumeration Date | 03/20/2019 |
| Last Update Date | 03/05/2024 |
| Certification Date | 03/05/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306306147 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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