Organization
INDIANA RE-ENTRY INTEGRATED SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL DWAYNE JAMES LCAC (CEO)
(317) 263-6573
Entity
Organization
Contact information
Practice address
3301 BROUSE AVE, INDIANAPOLIS, IN 46218-2018
(317) 263-6573
Mailing address
3301 BROUSE AVE, INDIANAPOLIS, IN 46218-2018
(317) 263-6573
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
01/18/2023
Last updated
01/18/2023
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