Organization
EXTRA SPECIAL PARENTS OF INDIANA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBORAH OOLEY MS (VICE PRESIDENT)
(812) 274-0228
Entity
Organization
Contact information
Practice address
402 W MAIN ST, MADISON, IN 47250-3717
(812) 274-0228
(812) 274-0466
Mailing address
402 W MAIN ST, MADISON, IN 47250-3717
(812) 274-0228
(812) 274-0466
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
16890ASO
IN
Other
Enumeration date
04/08/2015
Last updated
04/08/2015
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