Provider Demographics
NPI:1851740302
Name:CALMARE TREATMENT CENTER
Entity Type:Organization
Organization Name:CALMARE TREATMENT CENTER
Other - Org Name:DOL DOCTORS INDIANA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING EMPLOYEE
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:JOE
Authorized Official - Last Name:TOLLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:317-442-1515
Mailing Address - Street 1:7430 N SHADELAND AVE STE 230
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2036
Mailing Address - Country:US
Mailing Address - Phone:317-991-5710
Mailing Address - Fax:317-755-1807
Practice Address - Street 1:7430 N SHADELAND AVE STE 230
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-2036
Practice Address - Country:US
Practice Address - Phone:317-991-5710
Practice Address - Fax:317-755-1807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-06
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
208D00000X, 363LX0106X
IN08001559A261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational HealthGroup - Multi-Specialty