Organization
REM INDIANA COMMUNITY SERVICE II, INC.
Active
Other names
Indana Mentor
Organization subpart
No
Provider details
NPI number
Authorized official
BRETT IAN COHEN (COO)
(800) 388-5150
Entity
Organization
Contact information
Practice address
8925 N MERIDIAN ST, SUITE 200, INDIANAPOLIS, IN 46260-2386
(317) 581-2380
(317) 581-2378
Mailing address
8925 N MERIDIAN ST, SUITE 200, INDIANAPOLIS, IN 46260-2386
(317) 581-2380
(317) 581-2378
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
200300350
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200300350
—
IN
Enumeration date
03/15/2007
Last updated
04/22/2023
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