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Organization

INDIANA CLINIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JANE ANN OLISE-AIKINS LCSW (ASSESSMENT SPECIALIST)
(317) 962-2622
Entity
Organization

Contact information

Practice address
1701 N SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 962-2622
(317) 963-8252
Mailing address
1701 N SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 962-2622
(317) 963-8252

Taxonomy

Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2000119790
IN
Enumeration date
07/15/2010
Last updated
07/15/2010
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