Organization
INPUT RESIDENTIAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TANYA DAVIS (CEO)
(317) 222-9888
Entity
Organization
Contact information
Practice address
8117 E WASHINGTON ST, INDIANAPOLIS, IN 46219-6813
(317) 222-9888
Mailing address
8117 E WASHINGTON ST, INDIANAPOLIS, IN 46219-6813
(317) 222-9888
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
251C0000X
IN
Other
Enumeration date
01/25/2018
Last updated
01/25/2018
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