| Richard J K Grana Inc | |
|
9240 N Meridian St Ste 320 Indianapolis IN 46260-1880 | |
| (317) 844-7489 | |
| (317) 581-0007 |
| Full Name | Richard J K Grana Inc |
|---|---|
| Speciality | Psychologist |
| Location | 9240 N Meridian St, Indianapolis, Indiana |
| Authorized Official Name and Position | Richard Grana (OWNER) |
| Authorized Official Contact | 3178447489 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Richard J K Grana Inc 9240 N Meridian St Ste 320 Indianapolis IN 46260-1880 Ph: () - | Richard J K Grana Inc 9240 N Meridian St Ste 320 Indianapolis IN 46260-1880 Ph: (317) 844-7489 |
| NPI Number | 1023405578 |
|---|---|
| Provider Enumeration Date | 04/22/2015 |
| Last Update Date | 05/08/2024 |
| Certification Date | 05/08/2024 |
| Medicare PECOS PAC ID | 0042531899 |
|---|---|
| Medicare Enrollment ID | O20150604001365 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023405578 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 20090217A (Indiana) | Primary |
| Provider Name | Richard Joseph Grana |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1972555894 PECOS PAC ID: 0648335794 Enrollment ID: I20100114000131 |
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