Individual
MR. ROGER LEE HIGGINS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6104 W LAKE SOUTH DR, APT A, INDIANAPOLIS, IN 46224-7647
(317) 603-2694
Mailing address
6104 W LAKE SOUTH DR, APT A, INDIANAPOLIS, IN 46224-7647
(317) 603-2694
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/25/2008
Last updated
08/25/2008
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