Organization
FIRST CHURCH OF DELIVERANCE AND RECOVERY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. FELICIA ANN SMITH MENTAL HEALTH (PROGRAM DIRECTOR)
(317) 679-2311
Entity
Organization
Contact information
Practice address
1424 N TIBBS AVE, INDIANAPOLIS, IN 46222-3026
(317) 602-5908
Mailing address
1424 N TIBBS AVE, INDIANAPOLIS, IN 46222-3026
(317) 602-5908
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300005347
—
IN
Enumeration date
06/27/2018
Last updated
06/27/2018
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