Organization
ADULT AND CHILD MHC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH F BREYER (CFO)
(317) 882-5122
Entity
Organization
Contact information
Practice address
8320 MADISON AVE, INDIANAPOLIS, IN 46227-6066
(317) 882-5122
(317) 888-8642
Mailing address
8320 MADISON AVE, INDIANAPOLIS, IN 46227-6066
(317) 882-5122
(317) 888-8642
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
34005892A
IN
Other
Enumeration date
11/14/2011
Last updated
11/14/2011
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