Provider Demographics
NPI:1114237336
Name:GREENHOUSE AND ASSOCIATES INC.
Entity Type:Organization
Organization Name:GREENHOUSE AND ASSOCIATES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:LANDESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-698-8720
Mailing Address - Street 1:P.O. BOX 55107
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46205
Mailing Address - Country:US
Mailing Address - Phone:317-253-7387
Mailing Address - Fax:317-253-7388
Practice Address - Street 1:3016 LAKE SHORE DRIVE
Practice Address - Street 2:STE E
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46205
Practice Address - Country:US
Practice Address - Phone:317-253-7387
Practice Address - Fax:317-253-7388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-21
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN99044249A103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty