Provider Demographics
NPI:1578253233
Name:HEALTH ASSOCIATES INDY
Entity Type:Organization
Organization Name:HEALTH ASSOCIATES INDY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JERAD
Authorized Official - Middle Name:
Authorized Official - Last Name:DALTON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:317-844-7489
Mailing Address - Street 1:9240 N MERIDIAN ST STE 320
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-1822
Mailing Address - Country:US
Mailing Address - Phone:317-844-7489
Mailing Address - Fax:317-581-1007
Practice Address - Street 1:9240 N MERIDIAN ST STE 320
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-1822
Practice Address - Country:US
Practice Address - Phone:317-844-7489
Practice Address - Fax:317-581-1007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-08
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty