Organization
OVERDOSE LIFELINE, INC.
Active
Other names
Overdose Lifeline, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JUSTIN KAY PHILLIPS MA (EXECUTIVE DIRECTOR)
(317) 828-6883
Entity
Organization
Contact information
Practice address
1100 W 42ND ST STE 345, INDIANAPOLIS, IN 46208-3345
(844) 554-3354
Mailing address
1100 W 42ND ST STE 345, INDIANAPOLIS, IN 46208-3345
(844) 554-3354
Taxonomy
Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
251V00000X
Voluntary or Charitable Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QM2800X
Methadone Clinic
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
261QR0800X
Recovery Care Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
04/20/2018
Last updated
06/11/2019
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