Organization
BEHAVIORSOURCE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY DWAIN ADKINS (GENERAL MANAGER)
(317) 469-6347
Entity
Organization
Contact information
Practice address
9425 N MERIDIAN ST, SUITE 204, INDIANAPOLIS, IN 46260-1308
(317) 469-6347
(317) 580-9506
Mailing address
9425 N MERIDIAN ST, SUITE 204, INDIANAPOLIS, IN 46260-1308
(317) 469-6347
(317) 580-9506
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
34005028A
IN
Other
Enumeration date
01/11/2010
Last updated
01/11/2010
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