Organization
SERVICE ABOVE SELF, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AUSTIN O NWAKA CEO (PRESIDENT)
(317) 541-1836
Entity
Organization
Contact information
Practice address
3919 MEADOWS DR, BOX 421441, INDIANAPOLIS, IN 46205-3113
(317) 541-1836
Mailing address
3919 MEADOWS DR, INDIANAPOLIS, IN 46205-3113
(317) 541-1836
(317) 541-1858
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200427340
—
IN
Enumeration date
08/14/2006
Last updated
07/30/2008
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