Basic Information
| Provider Information | |||||||||
| NPI: | 1598005274 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VOLUNTEERS OF AMERICA OF INDIANA, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 927 N PENNSYLVANIA ST | ||||||||
| Address2: | |||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462041020 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3176869779 | ||||||||
| FaxNumber: | 3176865810 | ||||||||
| Practice Location | |||||||||
| Address1: | 927 N PENNSYLVANIA ST | ||||||||
| Address2: | |||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462041020 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3176869779 | ||||||||
| FaxNumber: | 3176865810 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/18/2013 | ||||||||
| LastUpdateDate: | 04/04/2019 | ||||||||
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| AuthorizedOfficialLastName: | VON ARX | ||||||||
| AuthorizedOfficialFirstName: | JON | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 3176869779 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNameSuffix: | III | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 20010356A | IN | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist | Clinical | 324500000X | N | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | 103TA0400X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist | Addiction (Substance Use Disorder) |
No ID Information.