Organization
BETHLEHEM HOUSE RESIDENCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NATHAN L RUSH (EXECUTIVE DIRECTOR)
(317) 920-1519
Entity
Organization
Contact information
Practice address
130 E 30TH ST, INDIANAPOLIS, IN 46205-3904
(317) 920-1519
(317) 920-1515
Mailing address
130 E 30TH ST, INDIANAPOLIS, IN 46205-3904
(317) 920-1519
(317) 920-1515
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
07/10/2015
Last updated
07/10/2015
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