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Organization

BEHAVIORCORP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. TIMOTHY CROCKET (CFO)
(317) 587-0505
Entity
Organization

Contact information

Practice address
9615 E 148TH ST, SUITE 1, NOBLESVILLE, IN 46060-4360
(317) 587-0500
(317) 674-0060
Mailing address
9615 E 148TH ST, SUITE 1, NOBLESVILLE, IN 46060-4360
(317) 587-0500
(317) 674-0060

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200047810A
IN
Enumeration date
12/05/2006
Last updated
11/14/2024
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