Organization
DYVYNE INTERVENTYON PROGRAMS & SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REGYNA YATES (CEO/EXECUTIVE DIRECTOR)
(615) 499-2943
Entity
Organization
Contact information
Practice address
5555 N TACOMA AVE STE 203, INDIANAPOLIS, IN 46220-3547
(317) 372-7657
Mailing address
5555 N TACOMA AVE STE 203, INDIANAPOLIS, IN 46220-3547
(317) 372-7657
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
IN
Other
Enumeration date
07/14/2014
Last updated
07/14/2014
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