| Restored Pieces Llc | |
|
7210 Mars Dr Indianapolis IN 46241-3693 | |
| (317) 721-1719 | |
| Not Available |
| Full Name | Restored Pieces Llc |
|---|---|
| Speciality | Social Worker |
| Location | 7210 Mars Dr, Indianapolis, Indiana |
| Authorized Official Name and Position | Jacqueline Peoples (OWNER) |
| Authorized Official Contact | 3177211719 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Restored Pieces Llc 7210 Mars Dr Indianapolis IN 46241-3693 Ph: (317) 721-1719 | Restored Pieces Llc 7210 Mars Dr Indianapolis IN 46241-3693 Ph: (317) 721-1719 |
| NPI Number | 1790396760 |
|---|---|
| Provider Enumeration Date | 08/13/2020 |
| Last Update Date | 08/13/2020 |
| Certification Date | 08/13/2020 |
| Medicare PECOS PAC ID | 3678976198 |
|---|---|
| Medicare Enrollment ID | O20210721002839 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790396760 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jacqueline Peoples |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831589142 PECOS PAC ID: 6507185584 Enrollment ID: I20150427000275 |
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