Organization
RIVERSIDE COMMUNITY CARE CLINIC OF INDIANA CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA ROBERTSON (MANAGER)
(615) 866-2731
Entity
Organization
Contact information
Practice address
7478 MADISON AVE, INDIANAPOLIS, IN 46227-5519
(615) 866-2731
(615) 866-2732
Mailing address
7478 MADISON AVE, INDIANAPOLIS, IN 46227-5519
(615) 866-2731
(615) 866-2732
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
04/21/2023
Last updated
04/21/2023
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