Provider Demographics
NPI:1750030714
Name:STANDING STRONG
Entity Type:Organization
Organization Name:STANDING STRONG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:MUWALLIF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-679-3159
Mailing Address - Street 1:3126 N CAMPBELL AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46218-2554
Mailing Address - Country:US
Mailing Address - Phone:317-679-3159
Mailing Address - Fax:
Practice Address - Street 1:1000 N BURNS ST
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47303-4004
Practice Address - Country:US
Practice Address - Phone:317-679-3159
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-18
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
No385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child