Provider Demographics
NPI:1518748391
Name:ADDICTION REHAB CENTERS AT INDIANAPOLIS
Entity Type:Organization
Organization Name:ADDICTION REHAB CENTERS AT INDIANAPOLIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHEA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-288-1160
Mailing Address - Street 1:486 MATTHEWS LN
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-4401
Mailing Address - Country:US
Mailing Address - Phone:718-288-1160
Mailing Address - Fax:
Practice Address - Street 1:7322 NOEL RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46278-1515
Practice Address - Country:US
Practice Address - Phone:844-551-4673
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility