Provider Demographics
NPI:1033398417
Name:NORTH MERIDIAN PSYCHIATRIC ASSOCIATES, INC.
Entity Type:Organization
Organization Name:NORTH MERIDIAN PSYCHIATRIC ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:H
Authorized Official - Last Name:ADINAMIS
Authorized Official - Suffix:X
Authorized Official - Credentials:MD
Authorized Official - Phone:317-663-7302
Mailing Address - Street 1:9302 N MERIDIAN ST
Mailing Address - Street 2:SUITE 225
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-1873
Mailing Address - Country:US
Mailing Address - Phone:317-663-7302
Mailing Address - Fax:317-735-9638
Practice Address - Street 1:9302 N MERIDIAN ST
Practice Address - Street 2:SUITE 225
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-1873
Practice Address - Country:US
Practice Address - Phone:317-663-7302
Practice Address - Fax:317-735-9638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-01
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN103316815261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100468910Medicaid