Organization
MENDING BRIDGES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTONIA S PHILLIPS (OWNER)
(317) 851-6710
Entity
Organization
Contact information
Practice address
2869 LUDWIG DR, INDIANAPOLIS, IN 46239-6930
(317) 851-6710
Mailing address
2869 LUDWIG DR, INDIANAPOLIS, IN 46239-6930
(317) 851-6710
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
—
—
Other
Enumeration date
08/20/2024
Last updated
08/20/2024
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