Organization
ENRICHING LIVES ORGANIZATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANET GRINSTEAD (OWNER)
(404) 956-7529
Entity
Organization
Contact information
Practice address
1775 N SHERMAN DR STE A, INDIANAPOLIS, IN 46218-4493
(404) 956-7529
Mailing address
4325 BLACK OAK DR, INDIANAPOLIS, IN 46228-3109
(404) 956-7529
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
87001214A
IN
101YP2500X
Professional Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D6703519
—
IN
Enumeration date
11/15/2017
Last updated
06/24/2019
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