| Password Community Mentoring, Inc. | |
|
4720 Kingsway Dr Ste 400 Indianapolis IN 46205-1580 | |
| (317) 585-2791 | |
| (317) 472-7899 |
| Full Name | Password Community Mentoring, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4720 Kingsway Dr Ste 400, Indianapolis, Indiana |
| Authorized Official Name and Position | Thomas R Huckstep (BUSINESS MANAGER) |
| Authorized Official Contact | 3174727903 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Password Community Mentoring, Inc. 4720 Kingsway Dr Ste 400 Indianapolis IN 46205-1580 Ph: (317) 585-2791 | Password Community Mentoring, Inc. 4720 Kingsway Dr Ste 400 Indianapolis IN 46205-1580 Ph: (317) 585-2791 |
| NPI Number | 1790954964 |
|---|---|
| Provider Enumeration Date | 02/21/2008 |
| Last Update Date | 02/21/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790954964 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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