Provider Demographics
NPI:1346428539
Name:GREATER OPPORTUNITY DEVELOPMENT AND SERVICES L.L.C
Entity Type:Organization
Organization Name:GREATER OPPORTUNITY DEVELOPMENT AND SERVICES L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:GIADAYNA
Authorized Official - Last Name:EDMONDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-897-1213
Mailing Address - Street 1:8240 MEADOWLARK DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46226-5343
Mailing Address - Country:US
Mailing Address - Phone:317-724-8797
Mailing Address - Fax:
Practice Address - Street 1:8240 MEADOWLARK DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46226-5343
Practice Address - Country:US
Practice Address - Phone:317-724-8797
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-10
Last Update Date:2008-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization