Organization
SHORE BEHAVIORAL LLC
Active
Other names
Ethan Crossing Addiction Campus of Indianapolis
Organization subpart
No
Provider details
NPI number
Authorized official
YITZCHAK ROSEDALE (PRESIDENT)
(513) 530-1808
Entity
Organization
Contact information
Practice address
4102 SHORE DR, INDIANAPOLIS, IN 46254-2608
(513) 489-7100
Mailing address
10123 ALLIANCE RD, BLUE ASH, OH 45242-4887
(513) 530-1808
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
09/24/2021
Last updated
05/01/2025
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