Organization
BETHLEHEM HOUSE RESIDENCE, INC
Active
Other names
THE BETHLEHEM HOSUE
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NATHAN L RUSH (EXECUTIVE DIRECTOR)
(317) 920-1519
Entity
Organization
Contact information
Practice address
130 E 30TH ST, INDIANAPOLIS, IN 46205-3904
(317) 920-1519
(317) 920-1515
Mailing address
130 E 30TH ST, INDIANAPOLIS, IN 46205-3904
(317) 920-1519
(317) 920-1515
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
11/30/2011
Last updated
11/30/2011
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