Provider Demographics
NPI:1356959068
Name:INDY BEHAVIORAL HEALTH LLC
Entity type:Organization
Organization Name:INDY BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SONYA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:RUEDLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:317-978-0257
Mailing Address - Street 1:2629 WATERFRONT PARKWAY EAST DR STE 375
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46214-2026
Mailing Address - Country:US
Mailing Address - Phone:317-978-0257
Mailing Address - Fax:317-974-9077
Practice Address - Street 1:2629 WATERFRONT PARKWAY EAST DR STE 375
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46214-2026
Practice Address - Country:US
Practice Address - Phone:317-978-0257
Practice Address - Fax:317-974-9077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-20
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty