Provider Demographics
NPI:1457875460
Name:INDIANA DEPARTMENT OF CHILD SERVICES
Entity Type:Organization
Organization Name:INDIANA DEPARTMENT OF CHILD SERVICES
Other - Org Name:INDIANA DEPARTMENT OF CHILD SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AGENCY HEAD/DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:BONAVENTURA
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:317-234-1391
Mailing Address - Street 1:302 W WASHINGTON ST RM E306
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-2738
Mailing Address - Country:US
Mailing Address - Phone:317-234-4443
Mailing Address - Fax:
Practice Address - Street 1:302 W WASHINGTON ST RM E306
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46204-2738
Practice Address - Country:US
Practice Address - Phone:317-234-4443
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STATE OF INDIANA AUDITOR OF STATE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-08-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare