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Organization

LIVING WELL IN COMPANY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. PAUL NELSON GEORGE M.S., L.C.S.W. (PRESIDENT)
(317) 475-1389
Entity
Organization

Contact information

Practice address
6284 RUCKER RD, SUITE N, INDIANAPOLIS, IN 46220-4865
(317) 475-1389
(317) 475-9089
Mailing address
6284 RUCKER RD, SUITE N, INDIANAPOLIS, IN 46220-4865
(317) 475-1389
(317) 475-9089

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
34002279A
IN
225100000X
Physical Therapist
05000996A
IN

Other

Enumeration date
01/14/2013
Last updated
01/14/2013
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