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Organization
FIRST CHURCH OF DELIVERANCE AND RECOVERY INC.
Active
Organization
FIRST CHURCH OF DELIVERANCE AND RECOVERY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. FELICIA ANN SMITH MENTAL HEALTH (PROGRAM DIRECTOR)
(317) 679-2311
Entity
Organization
Contact information
Practice address
1424 N TIBBS AVE, INDIANAPOLIS, IN 46222-3026
(317) 602-5908
Mailing address
1424 N TIBBS AVE, INDIANAPOLIS, IN 46222-3026
(317) 602-5908
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300005347
—
IN
Enumeration date
06/27/2018
Last updated
06/27/2018
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