Provider Demographics
NPI:1184492621
Name:ANEW THERAPY & WELLNESS LLC
Entity type:Organization
Organization Name:ANEW THERAPY & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:F
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-788-2500
Mailing Address - Street 1:6900 GRAY RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-3209
Mailing Address - Country:US
Mailing Address - Phone:812-371-7680
Mailing Address - Fax:317-739-4115
Practice Address - Street 1:8549 N MERIDIAN ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-2329
Practice Address - Country:US
Practice Address - Phone:317-788-2500
Practice Address - Fax:317-739-4115
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANEW THERAPY AND WELLNESS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-12-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty