Central Indiana Clubhouse Nfp Corp
NPI #1548610082 in Indianapolis, Indiana
Provider Information
- NPI Number
- 1548610082
- Entity Type
- Organization
- Organization Name
- Central Indiana Clubhouse Nfp Corp
- Primary Specialty
- Community/Behavioral Health
- Enumeration Date
- Jun 15, 2016
- Last Updated
- Jun 15, 2016
Practice Location
- Address
- 4141 OFFICE PLAZA BLVD
- City
- Indianapolis
- State
- Indiana
- ZIP Code
- 46254-2408
- Phone
- (317) 260-8058
Authorized Official
- Name
- JAY BRUBAKER, J.D.
- Title
- EXECUTIVE DIRECTOR
- Phone
- (317) 260-8058
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community/Behavioral Health |
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