Organization
CIRCLE CITY IOP LLC
Active
Other names
Circle City IOP
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES BENTZ (MANAGING PARTNER)
(310) 595-4905
Entity
Organization
Contact information
Practice address
6235 CARROLLTON AVE STE B, INDIANAPOLIS, IN 46220-1924
(310) 595-4905
Mailing address
6235 CARROLLTON AVE STE B, INDIANAPOLIS, IN 46220-1924
(310) 595-4905
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
07/04/2020
Last updated
04/13/2023
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