Provider Demographics
NPI:1558912436
Name:CASTLETON UNITED METHODIST CHURCH, INC.
Entity Type:Organization
Organization Name:CASTLETON UNITED METHODIST CHURCH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:PELLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-284-0837
Mailing Address - Street 1:7160 SHADELAND STA
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-3915
Mailing Address - Country:US
Mailing Address - Phone:317-284-0837
Mailing Address - Fax:
Practice Address - Street 1:7160 SHADELAND STA
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-3915
Practice Address - Country:US
Practice Address - Phone:317-284-0837
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CASTLETON UNITED METHODIST CHURCH, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-09-23
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201037840AMedicaid